关键词: Airway management Critical care Cuidado crítico Infección por SARS-CoV Insuficiencia respiratoria Intubación traqueal Manejo de la vía aérea Respiratory failure SARS-CoV infection Tracheal intubation

Mesh : Adult Humans SARS-CoV-2 COVID-19 Critical Illness Respiratory Insufficiency Respiratory Distress Syndrome Hypoxia Heart Arrest

来  源:   DOI:10.1016/j.medine.2022.08.005

Abstract:
Few studies have reported the implications and adverse events of performing endotracheal intubation for critically ill COVID-19 patients admitted to intensive care units. The aim of the present study was to determine the adverse events related to tracheal intubation in COVID-19 patients, defined as the onset of hemodynamic instability, severe hypoxemia, and cardiac arrest.
Tertiary care medical hospitals, dual-centre study performed in Northern Italy from November 2020 to May 2021.
Adult patients with positive SARS-CoV-2 PCR test, admitted for respiratory failure and need of advanced invasive airways management.
Endotracheal Intubation Adverse Events.
The primary endpoint was to determine the occurrence of at least 1 of the following events within 30 minutes from the start of the intubation procedure and to describe the types of major adverse peri-intubation events: severe hypoxemia defined as an oxygen saturation as measured by pulse-oximetry <80%; hemodynamic instability defined as a SBP 65 mmHg recoded at least once or SBP < 90 mmHg for 30 minutes, a new requirement or increase of vasopressors, fluid bolus >15 mL/kg to maintain the target blood pressure; cardiac arrest.
Among 142 patients, 73.94% experienced at least one major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 65.49% of all patients undergoing emergency intubation, followed by severe hypoxemia (43.54%). 2.82% of the patients had a cardiac arrest.
In this study of intubation practices in critically ill patients with COVID-19, major adverse peri-intubation events were frequent.
www.
gov identifier: NCT04909476.
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