Articles: intensive-care-units.
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A prospective study of all unplanned adult extubations was conducted for 4 months period in four intensive care units (ICUs) of a community hospital. Our objective was to document the incidence of unplanned extubations, discern possible variables predictive of occurrence and outcome, and formulate preventive measures and guidelines for reintubation. ⋯ Our data suggested that self-extubation is relatively rare in our institution and that about half of self-extubated patients were reintubated. Staff vigilance, a proper weaning period, and the nasal method of intubation were some of the factors to which we attributed this low occurrence rate. However, a larger patient study population is required to show conclusively effective preventive measures and establish guidelines for reintubation.
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To determine the excess length of stay, extra costs, and mortality attributable to nosocomial bloodstream infection in critically ill patients. ⋯ The attributable mortality from nosocomial bloodstream infection is high in critically ill patients. The infection is associated with a doubling of the SICU stay, an excess length of hospital stay of 24 days in survivors, and a significant economic burden.