Reintubation in patients with acute poisoning: Risk factor analysis

Abstract

Background: Endotracheal intubation is one of the most common interventions in the intensive care unit to provide a reliable airway for patients. We investigated the causes of endotracheal reintubation in cases with poisoning admitted to the intensive care unit. Methods: In this case-control study, 43 patients required endotracheal reintubation (case group) and 45 patients in the control group with only one time endotracheal intubation were compared according to clinical, paraclinical, and post-treatment sign and symptoms. Findings: There was a significant difference between the two groups based on the cause of consumption of drug or poison (suicide, accidental, or unspecified) (P < 0.050). In the group with reintubation, opioid poisoning was more common. Most of the patients in the reintubation group (55.8) were recovered with complications. However, most patients in the control group (64.4) were recovered without complications (P < 0.050). The duration of hospitalization in case group was significantly higher than control group (P = 0.004). Patients with accidental poisoning had less chance of reintubation Odds ratio (OR) = 0.32; 95% of confidence interval (95%CI) = 0.12-0.89; P= 0.020. Whereas, spontaneous extubation increased the risk of reintubation (OR = 8.30; 95%CI = 1.73-39.67; P = 0.008). Moreover, the possibility of reintubation was higher in spontaneous extubation. Conclusion: Spontaneous extubation and the cause of poisoning are predictive factors for reintubation. In cases where the patient needs endotracheal reintubation, the duration of hospitalization and complications are higher. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved.