Self-extubation Laryngeal Injuries at an Academic Tertiary Care Center: A Retrospective Pilot Study.

Self-extubation Laryngeal Injuries at an Academic Tertiary Care Center: A Retrospective Pilot Study.

Ann Otol Rhinol Laryngol. 2017 May 01;:3489417709795

Authors: Cohn JE, Touati A, Lentner M, Weitzel M, Fisher C, Sataloff RT

Abstract
OBJECTIVES: The purpose of this study is to identify laryngeal symptoms and injuries in self-extubated patients.
METHODS: A retrospective chart review was conducted to identify symptoms and clinical findings associated with self-extubation. A novel scoring system was developed and used to quantify these findings. Symptom score included all symptoms that patients reported after self-extubation. Clinical score consisted of laryngeal findings visualized on nasopharyngeal laryngoscopy. Finally, a total self-extubation score was calculated as the sum of the symptom and clinical scores. Additionally, duration of intubation and endotracheal tube size were correlated with these scores.
RESULTS: Sixty (n = 60) patients who self-extubated in our institution's intensive care unit were identified. Average calculated symptom, clinical, and total self-extubation scores were 0.92, 1.43, and 2.35, respectively. The most common symptom observed was hoarseness (62%), while the most common clinical finding was posterior laryngeal edema (58%). A significant positive correlation was found between duration of intubation and both symptom score and total self-extubation score (r = 0.314, P = .008 and r = 0.223, P = .05, respectively). Symptom score predicted clinical score with a significant positive correlation present (r = 0.278, P = .02).
CONCLUSIONS: This study demonstrates that the majority of self-extubated patients have laryngeal symptoms and clinical findings. A comprehensive, multidisciplinary evaluation is warranted for self-extubations.

PMID: 28503976 [PubMed - as supplied by publisher]

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