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  • 1.
    Lejon, Linda
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Stenermark, Karin
    Halmstad University, School of Social and Health Sciences (HOS).
    Utvärdering av extubationsparametrar på neurointensivvårdspatienter2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In the interest of patient safety it is of importance to extubate intensive care patients at the exact right moment. In the case of intensive care patients in neurocritical care special considerations have to be taken into account. Assessments done in general intensive care is not directly applicable to neurocritical care, since the neurologic injury can affect the patients ability to breathe.

    Objective: Through the examination of medical records this study aims to evaluate parameters that prior research has found to be conductive to a successful extubation of patients in neurocritical care.

    Method: A prospective study with inferential quantitative design. The study was performed in a neurocritical care ward in Sweden. The patients were included continuously as they were extubated. Medical records were examined in order to gather parameters in connection to the extubation of the 108 included neurocritical care patients.  Descriptive and analytical statistics, including significance analysis, was performed using IBM SPSS Statistics 20.Result: The study showed that the parameter “secretion texture” affected the extubation outcome for the patients in neurocritical care. There was also a tendency that the level of consciousness influenced extubation outcome. The other gathered parameters concerning breathing and circulation, cough strength, swallowing function and secretion volume showed no significant differences between the groups ”successful” and ”failed” extubation. Regarding the parameters for breathing and circulation, the majority of the patients, irrespective of extubation outcome, were extubated with conditions that generally complied with established recommendations.

    Conclusion: Parameters concerning breathing and circulation do not predict extubation outcome in a neurocritical care setting. There was however a significant difference between the groups for the parameter secretion texture. The tendency that the level of consciousness affected extubation outcome is of clinical relevance. To increase the level of patient safety concerning extubation of neurocritical care patients further research is required to enable the intensive care nurse to make an assessment of high quality and safety.

    Download full text (pdf)
    Utvärdering av extubationsparametrar på neurointensivvårdspatienter
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