Prospective study of unplanned extubation of neonatal with gastric tube / 中国综合临床

ABSTRACT

Objective To analyze the cause of neonatal unplanned extubation( UEX)of gastric tube as well as explore the strategies. Methods Seven hundred and sixteen neonates with gastric tube were registered. Their intubation time,intubation aim,extubation time,extubation reasons of unplanned extubation of gastric tube were recorded and analyzed. Results The incidence of UEX of gastric tube was 13. 3%(95 cases) and 1. 54 per 100 tube days in the neonates. The incidences of UEX in channel orally and body unrestraint were 33. 6%(46/137)and 24. 3%(42/173),higher than that of nasopharyngeal tube(18. 5%(49/579))and body restraint(9. 8%( 53/543 )),and the difference was significant( P = 0. 046,0. 004 ). Incidence of UEX in adhesive tape fixing group was 18. 1%( 23/127 ),higher than in bandage group( 11. 4%( 41/359 )) and transparent dressing group(9. 4%(31/330)),and the difference was significant(P=0. 034). Incidence of UEX caused by doctors or nurses was 24. 2%(23/95). There were more UEX from 12 to 14 O'clock and 22 to 1 O'clock. The channel of gastric tube( Oral cavity and nasopharynx,P = 0. 031,RR = 1. 563,95% CI 1. 205-2. 341),fixing method of tube( tape,bandage and transparent dressing,P=0. 004,RR=1. 492,95%CI 1. 320-3. 541)and body restraint(had/hadn't,P=0. 021,RR=1. 298,95%CI 1. 087-3. 271)were the influence factors of UEX. Conclusion The approaches including selecting nasal cavity as the tube channel,effective fixing of the tube,proper body restraint,perfect wandering round and standard nursing practicing are effective strategies to prevent UEX of gastric tube.