COVID-EX. Influence of the COVID-19 pandemic on the rate of unplanned extubations (UE) in intensive care units (ICUs): A case-control study

Context: In ICUs, many patients are intubated. UE is an indicator of the quality of care.
Isolation associated with “air” precautions may increase the number of UEs in mechanically ventilated (MV) COVID patients.
The main aim of the study was to compare the rate of UE between a COVID-19 period and a control period. The secondary aims were to identify UE risk factors and to study the experience of caregivers during the COVID-19 period.
Method: The method of choice was a retrospective single center case-control study. MV patients aged ≥ 18 years were eligible in two periods: the control period from 01/02/2020 to 29/02/2020, and the COVID-19 period from 01/03/2020 to 31/03/2020. An anonymous survey was given to ICU caregivers in Vannes Hospital.
Results: The UE rate was 17% (n=7) vs. 20% (n=9) control period vs. COVID-19 period (p=0.58), with nocturnal preponderance (75%). A quarter (n=4) of patients fulfill MV weaning criteria at the time of UE. A 71% (n=49) survey response rate was obtained. The COVID-19 period had a higher estimated UE risk for 76% (n=37) of caregivers, who felt that they had a greater workload, difficulties with monitoring, and decreased regular visits to patients’ rooms.
Conclusion: Contrary to the caregiver experience, we reported a similar UE rate over both the COVID-19 period and the control period.