Cargando…
Emergency Tracheal Intubation in Patients with COVID-19: A Single-center, Retrospective Cohort Study
INTRODUCTION: The objective of this study was to compare airway management technique, performance, and peri-intubation complications during the novel coronavirus pandemic (COVID-19) using a single-center cohort of patients requiring emergent intubation. METHODS: We retrospectively collected data on...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Department of Emergency Medicine, University of California, Irvine School of Medicine
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203023/ https://www.ncbi.nlm.nih.gov/pubmed/34125046 http://dx.doi.org/10.5811/westjem.2020.2.49665 |
_version_ | 1783708085186985984 |
---|---|
author | Hawkins, Andrew Stapleton, Stephanie Rodriguez, Gerardo Gonzalez, R. Mauricio Baker, William E. |
author_facet | Hawkins, Andrew Stapleton, Stephanie Rodriguez, Gerardo Gonzalez, R. Mauricio Baker, William E. |
author_sort | Hawkins, Andrew |
collection | PubMed |
description | INTRODUCTION: The objective of this study was to compare airway management technique, performance, and peri-intubation complications during the novel coronavirus pandemic (COVID-19) using a single-center cohort of patients requiring emergent intubation. METHODS: We retrospectively collected data on non-operating room (OR) intubations from February 1–April 23, 2020. All patients undergoing emergency intubation outside the OR were eligible for inclusion. Data were entered using an airway procedure note integrated within the electronic health record. Variables included level of training and specialty of the laryngoscopist, the patient’s indication for intubation, methods of intubation, induction and paralytic agents, grade of view, use of video laryngoscopy, number of attempts, and adverse events. We performed a descriptive analysis comparing intubations with an available positive COVID-19 test result with cases that had either a negative or unavailable test result. RESULTS: We obtained 406 independent procedure notes filed between February 1–April 23, 2020, and of these, 123 cases had a positive COVID-19 test result. Residents performed fewer tracheal intubations in COVID-19 cases when compared to nurse anesthetists (26.0% vs 37.4%). Video laryngoscopy was used significantly more in COVID-19 cases (91.1% vs 56.8%). No difference in first-pass success was observed between COVID-19 positive cases and controls (89.4% vs. 89.0%, p = 1.0). An increased rate of oxygen desaturation was observed in COVID-19 cases (20.3% vs. 9.9%) while there was no difference in the rate of other recorded complications and first-pass success. DISCUSSION: An average twofold increase in the rate of tracheal intubation was observed after March 24, 2020, corresponding with an influx of COVID-19 positive cases. We observed adherence to society guidelines regarding performance of tracheal intubation by an expert laryngoscopist and the use of video laryngoscopy. |
format | Online Article Text |
id | pubmed-8203023 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Department of Emergency Medicine, University of California, Irvine School of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-82030232021-06-21 Emergency Tracheal Intubation in Patients with COVID-19: A Single-center, Retrospective Cohort Study Hawkins, Andrew Stapleton, Stephanie Rodriguez, Gerardo Gonzalez, R. Mauricio Baker, William E. West J Emerg Med Critical Care INTRODUCTION: The objective of this study was to compare airway management technique, performance, and peri-intubation complications during the novel coronavirus pandemic (COVID-19) using a single-center cohort of patients requiring emergent intubation. METHODS: We retrospectively collected data on non-operating room (OR) intubations from February 1–April 23, 2020. All patients undergoing emergency intubation outside the OR were eligible for inclusion. Data were entered using an airway procedure note integrated within the electronic health record. Variables included level of training and specialty of the laryngoscopist, the patient’s indication for intubation, methods of intubation, induction and paralytic agents, grade of view, use of video laryngoscopy, number of attempts, and adverse events. We performed a descriptive analysis comparing intubations with an available positive COVID-19 test result with cases that had either a negative or unavailable test result. RESULTS: We obtained 406 independent procedure notes filed between February 1–April 23, 2020, and of these, 123 cases had a positive COVID-19 test result. Residents performed fewer tracheal intubations in COVID-19 cases when compared to nurse anesthetists (26.0% vs 37.4%). Video laryngoscopy was used significantly more in COVID-19 cases (91.1% vs 56.8%). No difference in first-pass success was observed between COVID-19 positive cases and controls (89.4% vs. 89.0%, p = 1.0). An increased rate of oxygen desaturation was observed in COVID-19 cases (20.3% vs. 9.9%) while there was no difference in the rate of other recorded complications and first-pass success. DISCUSSION: An average twofold increase in the rate of tracheal intubation was observed after March 24, 2020, corresponding with an influx of COVID-19 positive cases. We observed adherence to society guidelines regarding performance of tracheal intubation by an expert laryngoscopist and the use of video laryngoscopy. Department of Emergency Medicine, University of California, Irvine School of Medicine 2021-05 2021-05-17 /pmc/articles/PMC8203023/ /pubmed/34125046 http://dx.doi.org/10.5811/westjem.2020.2.49665 Text en Copyright: © 2021 Hawkins et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Critical Care Hawkins, Andrew Stapleton, Stephanie Rodriguez, Gerardo Gonzalez, R. Mauricio Baker, William E. Emergency Tracheal Intubation in Patients with COVID-19: A Single-center, Retrospective Cohort Study |
title | Emergency Tracheal Intubation in Patients with COVID-19: A Single-center, Retrospective Cohort Study |
title_full | Emergency Tracheal Intubation in Patients with COVID-19: A Single-center, Retrospective Cohort Study |
title_fullStr | Emergency Tracheal Intubation in Patients with COVID-19: A Single-center, Retrospective Cohort Study |
title_full_unstemmed | Emergency Tracheal Intubation in Patients with COVID-19: A Single-center, Retrospective Cohort Study |
title_short | Emergency Tracheal Intubation in Patients with COVID-19: A Single-center, Retrospective Cohort Study |
title_sort | emergency tracheal intubation in patients with covid-19: a single-center, retrospective cohort study |
topic | Critical Care |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203023/ https://www.ncbi.nlm.nih.gov/pubmed/34125046 http://dx.doi.org/10.5811/westjem.2020.2.49665 |
work_keys_str_mv | AT hawkinsandrew emergencytrachealintubationinpatientswithcovid19asinglecenterretrospectivecohortstudy AT stapletonstephanie emergencytrachealintubationinpatientswithcovid19asinglecenterretrospectivecohortstudy AT rodriguezgerardo emergencytrachealintubationinpatientswithcovid19asinglecenterretrospectivecohortstudy AT gonzalezrmauricio emergencytrachealintubationinpatientswithcovid19asinglecenterretrospectivecohortstudy AT bakerwilliame emergencytrachealintubationinpatientswithcovid19asinglecenterretrospectivecohortstudy |