The Reasons for High Reintubation Frequency in Intensive Care: A Retrospective Study

Abstract

Introduction: Mechanical ventilation is frequently applied in 3rd level intensive care units. Some patients may require reintu- bation due to positive fluid balance, electrolyte imbalances, prolonged mechanical ventilation, protein-energy imbalances, or age. Reintubation causes increase in morbidity and mortality in intensive care. Hence, we investigated the rates and causes of reintubation in our clinic. Methods: We retrospectively analyzed the files of patients hospitalized in intensive care during the 18-month period from June 1, 2018, to January 1, 2019. We recorded patients with successful intubation and patients who were reintubated. Results: Eighty-four patients who met the criteria were included in the study. The patients were studied under two groups, namely, 43 reintubated patients (51.2%) and 41 successfully extubated patients (48.8%). Mean age, Acute Physiology and Chronic Health Assessment II values, and comorbidity rates of the reintubation group were statistically significantly higher than of the successful extubation group. The rate of inotrope treatment (48.8%) in the reintubation group was statistically significantly higher than in the successful extubation group (14.6%). No statistically significant difference was found be - tween reintubation and successful extubation groups in terms of energy and protein intake. Discussion and Conclusion: Mechanical ventilation treatment in intensive care can usually be finished without any prob- lems. However, some patients may need mechanical ventilation treatment again. Reintubation can occur as an unexpected result of mechanical ventilation and increase mortality in intensive care. Reintubation-mortality relationship has been shown in many studies. Our study reports that mortality rate is approximately 2-fold in reintubated patients. Therefore, before plan- ning the extubation of patients, correcting the main problem causing respiratory support and reviewing other risk factors that may cause reintubation, will reduce the risk of reintubation.