Patient Safety and Unplanned Extubation in a Pediatric Intensive Care Unit: A Analytical Observational Study

Introduction: Unplanned extubation (UE) is characterized by the removal or displacement of the endotracheal tube (ETT). Objectives: To analyze the incidence of unplanned extubation, characterize the most prevalent cases of unplanned extubation and analyze an extubation protocol. Methodology: This study is characterized as an analytical observational study design, performed in two stages: field research to collect and analyze data from medical records and analysis of the NPE protocol used by a large hospital. Results: In the collected medical records, rates of 7.75 UE/100 days of MV for general and surgical ICU and 4.68 UE/100 days of MV for cardiopediatric ICU were found. The female gender was predominant in the group of patients evaluated and the cause of unknown origin was the most prevalent. We identified 19 unplanned extubations in the general and surgical ICU, and 9 episodes of unplanned extubation in the cardiopediatric ICU, 28 occurrences. For the protocol evaluation the AGREE II instrument was used and the following scores were obtained: domain 1 with 85.19%; domain 2 with 72.22%; domain 3 with 35.42%; domain 4 with 96.30%; domain 5 with 76.39% and domain 6 with 100%. The general score of the protocol evaluation was grade four. Conclusion: The data presented can be of great benefit for prevention, identification and early intervention of UE episodes in pediatric patients with higher risk factors.