Prevalence and outcomes of endotracheal intubation–related cardiac arrest in the ED
- Authors
- Ko, Byuk Sung; Ahn, Ryeok; Ryoo, Seung Mok; Ahn, Shin; Sohn, Chang Hwan; Seo, Dong Woo; Lim, Kyoung Soo; Kim, Won Young
- Issue Date
- Nov-2015
- Publisher
- MERICAN JO
- Citation
- The American journal of emergency medicine., v.33, no.11, pp.1642 - 1645
- Indexed
- SCIE
SCOPUS
- Journal Title
- The American journal of emergency medicine.
- Volume
- 33
- Number
- 11
- Start Page
- 1642
- End Page
- 1645
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/155876
- DOI
- 10.1016/j.ajem.2015.07.083
- ISSN
- 0735-6757
- Abstract
- BACKGROUND: Emergency endotracheal intubation-related cardiac arrest (CA) is not well documented. This study compares the clinical features and outcomes of intubation-related CA and other causes of inhospital CA. METHODS: All study patients were consecutive adults (≥18 years) who developed CA in the emergency department between January 2007 and December 2011. Emergent endotracheal intubation-related CA was defined as occurring within 20 minutes after successful intubation. Clinical variables were compared between patients with intubation-related CA and intubation-unrelated CA. The primary outcome was a good neurologic outcome defined as a Cerebral Performance Category score of 1 to 2. The secondary outcome was survival to hospital discharge. RESULTS: Of the 251 patients who developed CA, 41 were excluded due to trauma-related CA or "do-not-resuscitate" protocols, thereby leaving 210 patients. The prevalence of intubation-related CA was 23.3%, and the median duration between successful intubation and CA was 5.0 minutes (interquartile range, 2.0-9.5). Pulseless electrical activity was more commonly noted as the first arrest rhythm in the intubation-related CA group (75.5% vs 59.0%; P =.03) compared with patients with other causes of CA. However, the rates of good neurologic outcomes (14.3% vs 21.1%) and survival to discharge (34.7% vs 35.4%) were not significantly higher in intubation-related CA group (both P >.05). CONCLUSION: Endotracheal intubation-related CA occurred higher than commonly recognized, and patient outcomes were not better than other causes of CA. These data highlight the importance of efforts to prevent intubation-related CA. However, further prospective larger study will be required to generalize this result.
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