ICU患者非计划拔管行为动作特征分析

目的 明确ICU患者非计划拔管的动作特征，为非计划拔管智能识别与预警提供参考。方法 调取28例ICU患者非计划拔管全过程视频图像，对非计划拔管动作进行分析。结果 非计划拔管行为过程分为意图前期、意图拔管以及拔管完成，3个阶段时长比较，差异有统计学意义（P<0.05）。意图前期动作主要为上肢动作（82.1%），其次为头颈部动作（28.6%）；上肢摸索最高（53.6%），其次为抬手（25.0%）、触管（25.0%）等。拔管动作拇指、示指参与度均为100%，中指参与度为71.4%。结论 非计划拔管的意图前期持续时间最长，主要为上肢动作，表现为摸索、抬手、触管等，拇指和示指参与度最高。应引入计算机视觉技术早期识别异常行为，达到预警目的，以降低非计划拔管发生率，保障患者安全。

Movement characteristics of unplanned extubation in ICU patients

Objective To explore the main movement characteristics of unplanned extubation (UEX) in ICU patients, and to provide reference for abnormal activity recognition and early warning from artificial intelligence technologies. Methods The camera was mounted at the caudal side of the patient and UEX movements captured through the video cameras were analyzed. Results In total, 28 patients had UEX. The UEX process was divided into pre-intention stage, intention stage and extubation completion stage, showing significant difference in duration among the three stages (P<0.05). In the pre-intention stage, the upper limb appeared as the most involved body part (82.1%), followed by the head and neck (28.6%). The most frequent movement was upper-limb-groping (53.6%), followed by hand-lifting (25.0%), and touching the tube (25.0%), etc. The most involved fingers for extubation were the thumb and index finger (100%), followed by the middle finger (71.4%). Conclusion The duration of pre-intention stage was the longest in UEX, and upper limb movements such as groping, lifting and touching the tube were the most frequent. Thumb and index finger were most frequently involved. Artificial intelligence should be introduced to identify abnormal motion of UEX and achieve early warning, thus to reduce UEX and guarantee patient safety.