Accidental withdrawal of nonintravascular catheters in critically ill patients

Objective

The objective of this study was to analyze the incidence of accidental withdrawal of nonintravascular catheters in critical care.

Methods

A prospective study of patients admitted in a 24-bed medical–surgical intensive care unit (ICU) of a 650-bed university hospital, from 1 May 2000 to 31 October 2001, who needed a nonintravascular catheter.

Results

During this period of time 988 patients (60.12% man) were admitted in the ICU. The mean age was 55.63 ± 18.49 years, the APACHE II score was 13.65 ± 5.83, and the mortality was 14.37%. Patients' distribution was: 49.69% cardiac surgery, 8.60% cardiologic, 12.14% neurologic, 11.84% traumathology, 7.29% respiratory, 6.58% digestive, 2.93% intoxication. The number of patients with a nonintravascular catheter, the number of nonintravascular catheters and the days on risk for each catheter were: orotracheal tube, 803, 883 and 6054; nasogastric catheter, 861, 1402 and 7714; vesical catheter, 874, 1182 and 7883; thoracic drainage, 70, 98 and 529; abdominal drainage, 65, 112 and 746; intraventricular brain drainage, 68, 79 and 606; cardiac surgery drainage, 491, 982 and 2906. The number of accidental withdrawals of nonintravascular catheters per 100 catheters and per 100 days of catheterization were: orotracheal tube, 5.43 and 0.79; nasogastric catheter, 24.67 and 4.48; vesical catheter, 0.42 and 0.06; thoracic drainage, 3.06 and 0.56; abdominal drainage, 4.46 and 0.67; intraventricular brain drainage, 5.06 and 0.66; cardiac surgery drainage, 0.

Conclusions

The highest accidental removal was found in nasogastric catheters. It is necessary to develop more similar studies, studying accidental withdrawal of nonintravascular catheters per 100 catheters and per 100 days of catheterization, to establish standards for monitoring assistance quality.