metricas
covid
Buscar en
Revista Española de Anestesiología y Reanimación (English Edition)
Toda la web
Inicio Revista Española de Anestesiología y Reanimación (English Edition) Complications and degree of difficulty of orotracheal intubation in the Intensiv...
Journal Information
Vol. 71. Issue 1.
Pages 17-27 (January 2024)
Share
Share
Download PDF
More article options
Visits
5
Vol. 71. Issue 1.
Pages 17-27 (January 2024)
Original article
Complications and degree of difficulty of orotracheal intubation in the Intensive Care Unit before and after the establishment of an intubation protocol for critically ill patients: a prospective, observational study
Complicaciones y grado de dificultad de la intubación orotraqueal en la Unidad de Cuidados Intensivos pre-post instauración de un protocolo de intubación para el paciente crítico: Estudio prospectivo y observacional
Visits
5
M. Taboadaa,b,
Corresponding author
manutabo@yahoo.es

Corresponding author.
, X. Almeidaa,b, A. Cariñenaa,b, J. Costaa,b, J. Carmona-Mongea,b, A. Agildaa,b, L. Barreiroa,b, J. Castilloa,b, K. Williamsa,b, J. Segurolaa,b, J. Álvareza,b, T. Seoane-Pilladoc
a Unidad de Cuidados Intensivos, Servicio de Anestesia y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
b Fundación Instituto de Investigaciones Sanitarias (FIDIS), Santiago de Compostela, La Coruña, Spain
c Preventive Medicine and Public Health Unit, Department of Health Sciences, University of A Coruña-INIBIC, La Coruña, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (5)
Table 1. Recommendations for the intubation of the critically ill patient in the ICU based on the “Guidelines for the management of tracheal intubation in critically ill adults”.10
Table 2. Variables collected regarding the critically ill patients intubated in the Intensive Care Unit (ICU).
Table 3. Demographic data and characteristics of the patients intubated in the ICU.
Table 4. Comparison of the intubations performed during the periods studied.
Table 5. Frequency of complications during intubation in the two periods studied.
Show moreShow less
Additional material (1)
Abstract
Objective

The objective of our study was to compare the degree of difficulty and complications related to tracheal intubation in an Intensive Care Unit (ICU) before and after the introduction of an intubation protocol based on the Difficult Airway Society guidelines for the management of tracheal intubation in critically ill adults, published in 2018.

Methods

Prospective, observational study comparing all intubations performed in our ICU over 2 periods: pre-protocol (January 2015–January 2019) and post-protocol (February 2019–July 2022). The material used for intubation, the degree of difficulty, and intubation-related complications were recorded.

Results

During the study period, 661 patients were intubated - 437 in the pre-protocol period (96% by direct laryngoscopy) and 224 in the post-protocol period (53% with direct laryngoscopy, 46% with video laryngoscopy). We observed an improvement in laryngeal view in the post-protocol period compared to the pre-protocol period (Cormack–Lehane ≥ 2b in 7.6% vs. 29.8%, p < 0.001), and a decrease in the number of moderate-to-severely difficult intubations (6.7% vs. 17.4%, p < 0.001). The first-pass success rate was 92.8% in the post-protocol period compared to 90.2% pre-protocol (p = 0.508). We did not find significant differences in complications between the periods studied.

Conclusions

Intubations performed in the post-protocol period were associated with improved laryngeal view and fewer cases of difficult intubation compared with the pre-protocol period.

Keywords:
Difficult intubation
Video laryngoscope
Airway
Hypoxia
Intensive Care
Resumen
Objetivo

El objetivo de nuestro estudio fue comparar el grado de dificultad y las complicaciones relacionadas con la intubación orotraqueal en una Unidad de Cuidados Intensivos (UCI), pre y post instauración de un protocolo de intubación basado en la guía de práctica clínica para el manejo de la vía aérea difícil específica para el paciente crítico, publicada en 2018 por la Difficult Airway Society (UK).

Métodos

Estudio prospectivo, observacional, comparando todas las intubaciones realizadas en nuestra UCI en un periodo pre-protocolo (enero 2015–enero 2019) con un periodo post-protocolo (febrero 2019–julio 2022). Durante el procedimiento se registró el material utilizado para la intubación, grado de dificultad de intubación y complicaciones asociadas.

Resultados

Durante el periodo de estudio fueron intubados 661 pacientes, 437 en el periodo pre-protocolo (laringoscopia directa 96%) y 224 en el post-protocolo (laringoscopia directa 53%, videolaringoscopio 46%). En el periodo post-protocolo observamos una mejoría de la visión laringoscópica en comparación con el pre-protocolo (Cormack–Lehane ≥2b en el 7.6% vs. 29.8%, p < 0.001), y una disminución de las intubaciones calificadas de dificultad moderada-severa (6.7% vs. 17.4%, p < 0.001). La intubación al primer intento fue del 92.8% en el periodo post-protocolo respecto al 90.2% pre-protocolo (p = 0.508). No encontramos diferencias significativas en las complicaciones en los dos periodos estudiados.

Conclusiones

Las intubaciones realizadas en el periodo post-protocolo se han asociado a una mejoría de la visión laringoscópica y una menor dificultad de intubación en comparación con el periodo pre-protocolo.

Palabras clave:
Intubación difícil
Videolaringoscopio
Vía aérea
Hipoxia
Cuidados intensivos

Article

These are the options to access the full texts of the publication Revista Española de Anestesiología y Reanimación (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Anestesiología y Reanimación (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos