Prevention of unplanned endotracheal extubation in intensive care unit: An overview of systematic reviews

Nurs Open. 2023 Feb;10(2):392-403. doi: 10.1002/nop2.1317. Epub 2022 Aug 15.

Abstract

Aims: This study was performed to identify and summarize systematic reviews focusing on the prevention of unplanned endotracheal extubation in the intensive care unit.

Design: Overview of systematic reviews.

Methods: This overview was conducted according to the Preferred Reporting Items for Overviews of Systematic Reviews, including the harms checklist. A literature search of PubMed, the Cochrane Library, CINAH, Embase, Web of Science, SINOMED and PROSPERO was performed from January 1, 2005-June 1, 2021. A systematic review focusing on unplanned extubation was included, resulting in an evidence summary.

Results: Thirteen systematic reviews were included. A summary of evidence on unplanned endotracheal extubation was developed, and the main contents were risk factors, preventive measures and prognosis. The most important nursing measures were restraint, fixation of the tracheal tube, continuous quality improvement, psychological care and use of a root cause analysis for the occurrence of unplanned endotracheal extubation.

Conclusions: This overview re-evaluated risk factors and preventive measures for unplanned endotracheal extubation in the intensive care unit, resulting in a summary of evidence for preventing unplanned endotracheal extubation and providing direction for future research.

Trial registration details: The study was registered on the PROSPERO website.

Keywords: intensive care unit; intratracheal; intubation; nursing care; systematic review; unplanned extubation.

Publication types

  • Review

MeSH terms

  • Airway Extubation* / adverse effects
  • Airway Extubation* / methods
  • Airway Extubation* / nursing
  • Intensive Care Units / standards
  • Respiration, Artificial* / methods
  • Respiration, Artificial* / nursing
  • Risk Factors
  • Systematic Reviews as Topic