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.

Keywords

• Endotracheal intubation
• Poisoning
• Suicide