Unplanned extubation is an adverse event associated with endotracheal intubation and the use of invasive mechanical ventilation. Extubation failure and the need for reintubation are considered procedures that increase neonatal morbidity and mortality.

To analyze the characteristics of newborns who had an unplanned extubation event during their stay in a neonatal intensive care unit (NICU).

The data from this study belong to a multicenter study called “Predictive factors for extubation failure in newborns admitted to a NICU: a multicenter study”. Data were collected from hospitalization records from July 2017 to 2019. Newborns who used invasive mechanical ventilation through an orotracheal tube for at least 24 hours were included. Data collection was carried out in six NICUs in five Brazilian cities: Manaus-AM (North), Natal-RN (Northeast), Brasília-DF (Central-West), Belo Horizonte-MG (Southeast) and Florianópolis and São José-SC (South). The information extracted from the medical records was transcribed into Microsoft Office Excel, and the data were analyzed using the Statistical Package for Social Science - version 23.0. Results are presented as mean ± standard deviation, median (minimum and maximum amplitude) or absolute and relative frequency (n/%).

Of 516 records, 50 (9.6%) events of unplanned extubations were identified in 3 of the 5 cities representing the regions of Brazil, being North (n=7/14%), Midwest (n=11/22% ) and South (n=32/64%). The highest incidence of unplanned extubations was in premature newborns (n=36/72%), whose mean body weight on the day of the event was 2,312 ± 966 g. The median number of days on invasive mechanical ventilation was 5 (1-62) days. After unplanned extubation, 54% of the newborns needed non-invasive mechanical ventilation support (n=27) and 46% had failure and required reintubation in less than 48 hours (n=12), with a mean time between extubation and reintubation of 4.5 ± 13.72 hours.

Premature newborns weighing less than 2,500g presented, in this study, a higher incidence of unplanned extubation. In addition, the need for reintubation was frequent in the sample, thus indicating the adequacy of management during newborn care and handling of the endotracheal tube.

Knowing the characteristics of newborns with a higher incidence of unplanned extubation may improve care in the NICU, thus preventing the occurrence of adverse events.