Outcome of Self- and Planned Extubation in Organophosphate-Poisoned Patients

Background: Respiratory failure is the most common cause of morbidity and mortality in organophosphate (OP)-intoxicated patients. We aimed to assess and compare the need for re-intubation and outcome between patients with self-extubation (SE) and planned extubation (PE). Methods: All OP-poisoned endotracheally intubated patients admitted to poisoning ICU were included. The frequency and time of SE, need for re-intubation, and its impact on hospital stay and outcome were assessed. Results: In fifteen patients (48.4%) SE was reported. Need for re-intubation in these patients was more than those who underwent PE (60.0% vs. 37.5%; P = 0.2). Early unplanned SE significantly correlated with occurrence of pulmonary complications (P = 0.04). The rate of aspiration pneumonia was high (80%) in SE cases. Hospital stay was also significantly prolonged in these patients (14.6 vs. 5.4 days, P = 0.04). Conclusion: Planning for on-time weaning/extubation in OP-poisoned patients can prevent unplanned SE and decrease the occurrence of lung complications.