Tuesday, 28 May 2013

Outcomes of extubation in paediatric intensives care

Photo (3)Extubation outcome is important at the Royal Children’s Hospital PICU – 2/3 admissions result in intubation, and of those extubated 1/10 fail and require reintubation, becoming at increased risk of complications and mortality. At present there are a lot of unanswered questions about extubation in PICU: there are no strong predictors of outcome; the accuracy of clinician predictions hasn’t been investigated; and evidence for interventions to prevent failed extubation is weak and often conflicting.

Ms Jess Elliot is investigating some of these questions with a 6-month prospective observational cohort study and 12-month retrospective chart review for statistical power. Ms Elliott is a 4th year MBBS student doing a BMedSci Honours year at the SPHPM, under the supervision of Associate Professor David Pilcher, Associate Professor Warwick Butt, Professor Trevor Duke and Ms Carmel Delzoppo and is based at the Royal Children’s Hospital PICU.

She has been collecting data on clinician predictions and bedside clinical parameters/observations from immediately pre-extubation and 72hrs post-extubation, aiming to identify how accurate doctors and clinical parameters are at predicting extubation outcome, and what interventions can prevent its failure. She Hopes it will provide a much needed insight into extubation in PICU, with the ultimate goal of improving clinical practices and maximising patient outcomes.

So far she is 3 months into her project and has carried out over 280 extubations. She says “I am lucky to be surrounded by amazing and supportive doctors and staff. I’ve never learnt so much, so fast, or enjoyed it as much as I have this year – I would recommend it without hesitation”!

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