TITLE

Emergency endotracheal intubation-related adverse events in bronchial asthma exacerbation: can anesthesiologists attenuate the risk?

AUTHOR(S)
Ono, Yuko; Kikuchi, Hiroaki; Hashimoto, Katsuhiko; Sasaki, Tetsu; Ishii, Jyunya; Tase, Choichiro; Shinohara, Kazuaki
PUB. DATE
October 2015
SOURCE
Journal of Anesthesia;Oct2015, Vol. 29 Issue 5, p678
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: Airway management in severe bronchial asthma exacerbation (BAE) carries very high risk and should be performed by experienced providers. However, no objective data are available on the association between the laryngoscopist's specialty and endotracheal intubation (ETI)-related adverse events in patients with severe bronchial asthma. In this paper, we compare emergency ETI-related adverse events in patients with severe BAE between anesthesiologists and other specialists. Methods: This historical cohort study was conducted at a Japanese teaching hospital. We analyzed all BAE patients who underwent ETI in our emergency department from January 2002 to January 2014. Primary exposure was the specialty of the first laryngoscopist (anesthesiologist vs. other specialist). The primary outcome measure was the occurrence of an ETI-related adverse event, including severe bronchospasm after laryngoscopy, hypoxemia, regurgitation, unrecognized esophageal intubation, and ventricular tachycardia. Results: Of 39 patients, 21 (53.8 %) were intubated by an anesthesiologist and 18 (46.2 %) by other specialists. Crude analysis revealed that ETI performed by an anesthesiologist was significantly associated with attenuated risk of ETI-related adverse events [odds ratio (OR) 0.090, 95 % confidence interval (CI) 0.020-0.41, p = 0.001]. The benefit of attenuated risk remained significant after adjusting for potential confounders, including Glasgow Coma Score, age, and use of a neuromuscular blocking agent (OR 0.058, 95 % CI 0.010-0.35, p = 0.0020). Conclusions: Anesthesiologist as first exposure was independently associated with attenuated risk of ETI-related adverse events in patients with severe BAE. The skill and knowledge of anesthesiologists should be applied to high-risk airway management whenever possible.
ACCESSION #
110340303

 

Related Articles

  • Lesión traqueal secundaria a intubación durante una metastasectomía pulmonar abierta. Reporte de caso. Martínez-Alonso, Iván Azael; Barrios, Marino; Barrón-Ángeles, Juan Carlos Eder; Benita-Bordes, Antonio; Silva-Ortiz, José; Lever-Rosas, Carlos Daniel // Revista de Sanidad Militar;may/jun2014, Vol. 68 Issue 3, p196 

    The injury is a complication tracheal intubation secondary to anesthetic which increases postoperative morbidity and patient trans. This type of injury is not diagnosed immediately, but most of the time is in the immediate postoperative period. The most important risk factors are related to the...

  • Difficult Intubation Resulting in Surgical Repair of Esophageal and Hypopharyngeal Perforation. Wastler, Karen Erika // AANA Journal;Feb2015, Vol. 83 Issue 1, p21 

    Although rare, perilous injury of the aerodigestive tract due to traumatic endotracheal intubation can have devastating consequences for patient and provider. Resulting serious complications of injury may involve esophageal perforation, pneumomediastinum, mediastinitis, retropharyngeal abscess,...

  • Comparison of four techniques of nasogastric tube insertion in anaesthetised, intubated patients: A randomized controlled trial. Mandal, Mohan Chandra; Dolai, Sujata; Ghosh, Santanu; Mistri, Pallab Kumar; Roy, Rajiv; Basu, Sekhar Ranjan; Das, Sabyasachi // Indian Journal of Anaesthesia;Nov/Dec2014, Vol. 58 Issue 6, p714 

    Background and Aims: Insertion of nasogastric tubes (NGTs) in anaesthetised, intubated patients with a conventional method is sometimes difficult. Different techniques of NGT insertion have been tried with varying degree of success. The aim of this prospective, randomised, open-label study was...

  • In reply: Lingual traction to aid fiberoptic intubation. Ching, Yiu-Hei; Camporesi, Enrico; Mangar, Devanand // Journal of Anesthesia;Jun2015, Vol. 29 Issue 3, p483 

    A response from the authors of the article "Lingual traction to facilitate fiber-optic intubation of difficult airways: a single-anesthesiologist randomized trial" is presented.

  • Lingual traction to aid fiberoptic intubation. Liu, Jian; Xue, Fu; Liao, Xu // Journal of Anesthesia;Jun2015, Vol. 29 Issue 3, p482 

    A letter to the editor is presented in response to the article "Lingual traction to facilitate fiber-optic intubation of difficult airways: a single-anesthesiologist randomized trial" by Y. H. Ching and colleagues.

  • Effects of the Adverse Life Events and Disrupted in Schizophrenia-1 ( DISC1) Gene Polymorphisms on Acute Symptoms of Schizophrenia. Sayın, Aslıhan; Yüksel, Nevzat; Konac, Ece; Yılmaz, Akın; Doğan, Bilge; Tönge, Şule; Şahiner, Şafak; Menevşe, Adnan // DNA & Cell Biology;Feb2013, Vol. 32 Issue 2, p73 

    The aim of this study was to evaluate the effects of traumatic childhood events and recent adverse life events, as well as the Disrupted in Schizophrenia-1 ( DISC1) gene polymorphisms on types of last acute symptoms of patients with schizophrenia. Hundred patients with schizophrenia were given...

  • Kronik Obstrüktif AkciÄŸer Hastalığına Karşı Küresel GiriÅŸim Gold 2011: Yeni Rehberde Neler DeÄŸiÅŸti? ABUL, Yasin; ÖZLÜ, Tevfik // Turkiye Klinikleri Archives of Lung;SUP2012, Vol. 13 Issue S2, pS1 

    Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality in the world population. Global Initiative for Chronic Obstructive Lung Disease (GOLD) is a report and guide for the physicians who deal with the COPD. 2011 GOLD has mainly two goals. One is to relieve and...

  • Endobronchial valves for severe emphysema. Hartman, Jorine E.; Vanfleteren, Lowie E. G. W.; van Rikxoort, Eva M.; Klooster, Karin; Slebos, Dirk-Jan // European Respiratory Review;2019, Vol. 28 Issue 152, p1 

    The results of the randomised controlled trials investigating the bronchoscopic lung volume reduction treatment using endobronchial valves (EBV) are promising, and have led to their inclusion in treatment guidelines, US Food and Drug Administration approval and inclusion in routine care in an...

  • Incidence and predictors of major perioperative adverse cardiac and cerebrovascular events in non-cardiac surgery. Sabaté, S.; Mases, A.; Guilera, N.; Canet, J.; Castillo, J.; Orrego, C.; Sabaté, A.; Fita, G.; Parramón, F.; Paniagua, P.; Rodríguez, A.; Sabaté, M. // BJA: The British Journal of Anaesthesia;Dec2011, Vol. 107 Issue 6, p879 

    Background Major adverse cardiac and cerebrovascular events (MACCE) represent the most common cause of serious perioperative morbidity and mortality. Our aim was to identify risk factors for MACCE in a broad surgical population with intermediate-to-high surgery-specific risk and to build and...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics