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VOLUME 20 , ISSUE 2 ( 2016 ) > List of Articles


Airway accidents in critical care unit: A 3-year retrospective study in a Public Teaching Hospital of Eastern India

Sugata Dasgupta, Dipasri Bhattacharya, Shipti Shradha Singh, Arunima Chaudhuri, Sourav Das Choudhury

Keywords : Airway accidents, blocked tube, endotracheal tube, tracheostomy, unplanned extubations

Citation Information : Dasgupta S, Bhattacharya D, Singh SS, Chaudhuri A, Choudhury SD. Airway accidents in critical care unit: A 3-year retrospective study in a Public Teaching Hospital of Eastern India. Indian J Crit Care Med 2016; 20 (2):91-96.

DOI: 10.4103/0972-5229.175946

License: CC BY-ND 3.0

Published Online: 01-08-2013

Copyright Statement:  Copyright © 2016; The Author(s).


Background: Although tracheal tubes are essential devices to control and protect airway in a critical care unit (CCU), they are not free from complications. Aims: To document the incidence and nature of airway accidents in the CCU of a government teaching hospital in Eastern India. Methods: Retrospective analysis of all airway accidents in a 5-bedded (medical and surgical) CCU. The number, types, timing, and severity of airway accidents were analyzed. Results: The total accident rate was 19 in 233 intubated and/or tracheostomized patients over 1657 tube days (TDs) during 3 years. Fourteen occurred in 232 endotracheally intubated patients over 1075 endotracheal tube (ETT) days, and five occurred in 44 tracheostomized patients over 580 tracheostomy TDs. Fifteen accidents were due to blocked tubes. Rest four were unplanned extubations (UEs), all being accidental extubations. All blockages occurred during night shifts and all UEs during day shifts. Five accidents were mild, the rest moderate. No major accident led to cardiorespiratory arrest or death. All blockages occurred after 7th day of intubation. The outcome of accidents were more favorable in tracheostomy group compared to ETT group (P = 0.001). Conclusions: The prevalence of airway accidents was 8.2 accidents per 100 patients. Blockages were the most common accidents followed by UEs. Ten out of the 15 blockages and all 4 UEs were in endotracheally intubated patients. Tracheostomized patients had 5 blockages and no UEs.

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  1. Kapadia FN, Bajan KB, Raje KV. Airway accidents in intubated Intensive Care Unit patients: An epidemiological study. Crit Care Med 2000;28:659-64.
  2. Chatterjee A, Islam S, Divatia JV. Airway accidents in an Intensive Care Unit. Indian J Crit Care Med 2004;8:36-9.
  3. Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998;338:347-54.
  4. Coppolo DP, May JJ. Self-extubations. A 12-month experience. Chest 1990;98:165-9.
  5. Whelan J, Simpson SQ, Levy H. Unplanned extubation. Predictors of successful termination of mechanical ventilatory support. Chest 1994;105:1808-12.
  6. Epstein SK, Nevins ML, Chung J. Effect of unplanned extubation on outcome of mechanical ventilation. Am J Respir Crit Care Med 2000;161:1912-6.
  7. Smith RL, Planzos H. Unplanned extubation. Chest 1995;107:887-8.
  8. Listello D, Sessler CN. Unplanned extubation. Clinical predictors for reintubation. Chest 1994;105:1496-503.
  9. Jayamanne D, Nandipati R, Patel D. Self extubation a prospective study. Chest 1988;94:3S.
  10. Seudal I, Garner CV, Kaye W. Accidental extubation in the ICU. Chest 1992;102:1843S.
  11. Brown R, Gau P, Touleimat B. Unplanned extubations in a community hospital. Chest 1992;102:183S.
  12. O'Neil K. A prospective study of unplanned extubations. Chest 1992;102:183S.
  13. Tindol GA Jr., DiBenedetto RJ, Kosciuk L. Unplanned extubations. Chest 1994;105:1804-7.
  14. Kapadia FN, Tekawade PC, Nath SS, Pachpute SS, Saverkar SS, Bhise RA, et al. A prolonged observational study of tracheal tube displacements: Benchmarking an incidence <0.5-1% in a medical-surgical adult Intensive Care Unit. Indian J Crit Care Med 2014;18:273-7.
  15. MacIntyre NR, Cook DJ, Ely EW Jr., Epstein SK, Fink JB, Heffner JE, et al. Evidence-based guidelines for weaning and discontinuing ventilatory support: A collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest 2001;120 6 Suppl: 375S-95S.
  16. Ripoll I, Lindholm CE, Carroll R, Grenvik A. Spontaneous dislocation of endotracheal tubes. Anesthesiology 1978;49:50-2.
  17. Markowicz P, Ricard JD, Dreyfuss D, Mier L, Brun P, Coste F, et al. Safety, efficacy, and cost-effectiveness of mechanical ventilation with humidifying filters changed every 48 hours: A prospective, randomized study. Crit Care Med 2000;28:665-71.
  18. Thomachot L, Leone M, Razzouk K, Antonini F, Vialet R, Martin C. Randomized clinical trial of extended use of a hydrophobic condenser humidifier: 1 vs 7 days. Crit Care Med 2002;30:232-7.
  19. Lacherade JC, Auburtin M, Cerf C, Van de Louw A, Soufir L, Rebufat Y, et al. Impact of humidification systems on ventilator-associated pneumonia: A randomized multicenter trial. Am J Respir Crit Care Med 2005;172:1276-82.
  20. Kapadia FN. Unplanned extubations. Chest 1995;108:1768-70.
  21. Marx WH, Ciaglia P, Graniero KD. Some important details in the technique of percutaneous dilatational tracheostomy via the modified Seldinger technique. Chest 1996;110:762-6.
  22. Friedman Y, Fildes J, Mizock B, Samuel J, Patel S, Appavu S, et al. Comparison of percutaneous and surgical tracheostomies. Chest 1996;110:480-5.
  23. Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients. Am J Med 1981;70:65-76.
  24. Chew JY, Cantrell RW. Tracheostomy. Complications and their management. Arch Otolaryngol 1972;96:538-45.
  25. Skaggs JA, Cogbill CL. Tracheostomy: Management, mortality, complications. Am Surg 1969;35:393-6.
  26. Rogers LA. Complications of tracheostomy. South Med J 1969;62:1496-500.
  27. Yarington CT Jr., Frazer JP. Complications of tracheostomy. Arch Surg 1965;91:652-5.
  28. Dugan DJ, Samson PC. Tracheostomy: Present day indications and technics. Am J Surg 1963;106:290-306.
  29. Glas WW, King OJ Jr., Lui A. Complications of tracheostomy. Arch Surg 1962;85:56-63.
  30. Meade JW. Tracheotomy – Its complications and their management. A study of 212 cases. N Engl J Med 1961;265:519-23.
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