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Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay
BACKGROUND: Emergent airway management outside of the operating room is a high-risk procedure. Limited data exists about the indication and physiologic state of the patient at the time of intubation, the location in which it occurs, or patient outcomes afterward. METHODS: We retrospectively collecte...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889440/ https://www.ncbi.nlm.nih.gov/pubmed/31795993 http://dx.doi.org/10.1186/s12871-019-0894-4 |
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author | Yoon, Uzung Mojica, Jeffrey Wiltshire, Matthew Segna, Kara Block, Michael Pantoja, Anthony Torjman, Marc Wolo, Elizabeth |
author_facet | Yoon, Uzung Mojica, Jeffrey Wiltshire, Matthew Segna, Kara Block, Michael Pantoja, Anthony Torjman, Marc Wolo, Elizabeth |
author_sort | Yoon, Uzung |
collection | PubMed |
description | BACKGROUND: Emergent airway management outside of the operating room is a high-risk procedure. Limited data exists about the indication and physiologic state of the patient at the time of intubation, the location in which it occurs, or patient outcomes afterward. METHODS: We retrospectively collected data on all emergent airway management interventions performed outside of the operating room over a 6-month period. Documentation included intubation performance, and intubation related complications and mortality. Additional information including demographics, ASA-classification, comorbidities, hospital-stay, ICU-stay, and 30-day in-hospital mortality was obtained. RESULTS: 336 intubations were performed in 275 patients during the six-month period. The majority of intubations (n = 196, 58%) occurred in an ICU setting, and the rest 140 (42%) occurred on a normal floor or in a remote location. The mean admission ASA status was 3.6 ± 0.5, age 60 ± 16 years, and BMI 30 ± 9 kg/m(2). Chest X-rays performed immediately after intubation showed main stem intubation in 3.3% (n = 9). Two immediate (within 20 min after intubation) intubation related cardiac arrest/mortality events were identified. The 30-day in-hospital mortality was 31.6% (n = 87), the overall in-hospital mortality was 37.1% (n = 102), the mean hospital stay was 22 ± 20 days, and the mean ICU-stay was 14 days (13.9 ± 0.9, CI 12.1–15.8) with a 7.3% ICU-readmission rate. CONCLUSION: Patients requiring emergent airway management are a high-risk patient population with multiple comorbidities and high ASA scores on admission. Only a small number of intubation-related complications were reported but ICU length of stay was high. |
format | Online Article Text |
id | pubmed-6889440 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-68894402019-12-11 Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay Yoon, Uzung Mojica, Jeffrey Wiltshire, Matthew Segna, Kara Block, Michael Pantoja, Anthony Torjman, Marc Wolo, Elizabeth BMC Anesthesiol Research Article BACKGROUND: Emergent airway management outside of the operating room is a high-risk procedure. Limited data exists about the indication and physiologic state of the patient at the time of intubation, the location in which it occurs, or patient outcomes afterward. METHODS: We retrospectively collected data on all emergent airway management interventions performed outside of the operating room over a 6-month period. Documentation included intubation performance, and intubation related complications and mortality. Additional information including demographics, ASA-classification, comorbidities, hospital-stay, ICU-stay, and 30-day in-hospital mortality was obtained. RESULTS: 336 intubations were performed in 275 patients during the six-month period. The majority of intubations (n = 196, 58%) occurred in an ICU setting, and the rest 140 (42%) occurred on a normal floor or in a remote location. The mean admission ASA status was 3.6 ± 0.5, age 60 ± 16 years, and BMI 30 ± 9 kg/m(2). Chest X-rays performed immediately after intubation showed main stem intubation in 3.3% (n = 9). Two immediate (within 20 min after intubation) intubation related cardiac arrest/mortality events were identified. The 30-day in-hospital mortality was 31.6% (n = 87), the overall in-hospital mortality was 37.1% (n = 102), the mean hospital stay was 22 ± 20 days, and the mean ICU-stay was 14 days (13.9 ± 0.9, CI 12.1–15.8) with a 7.3% ICU-readmission rate. CONCLUSION: Patients requiring emergent airway management are a high-risk patient population with multiple comorbidities and high ASA scores on admission. Only a small number of intubation-related complications were reported but ICU length of stay was high. BioMed Central 2019-12-03 /pmc/articles/PMC6889440/ /pubmed/31795993 http://dx.doi.org/10.1186/s12871-019-0894-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Yoon, Uzung Mojica, Jeffrey Wiltshire, Matthew Segna, Kara Block, Michael Pantoja, Anthony Torjman, Marc Wolo, Elizabeth Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay |
title | Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay |
title_full | Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay |
title_fullStr | Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay |
title_full_unstemmed | Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay |
title_short | Emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and ICU stay |
title_sort | emergent airway management outside of the operating room – a retrospective review of patient characteristics, complications and icu stay |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889440/ https://www.ncbi.nlm.nih.gov/pubmed/31795993 http://dx.doi.org/10.1186/s12871-019-0894-4 |
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