Objective: 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. Setting: Tertiary care medical hospitals, dual-centre study performed in Northern Italy from November 2020 to May 2021. Patients: Adult patients with positive SARS-CoV-2 PCR test, admitted for respiratory failure and need of advanced invasive airways management. Interventions: Endotracheal Intubation Adverse Events. Main variables of interests: 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. Results: 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. Conclusion: In this study of intubation practices in critically ill patients with COVID-19, major adverse peri-intubation events were frequent. Clinical trial registration: www. Clinicaltrials: gov identifier: NCT04909476.

Airways management in SARS-COV-2 acute respiratory failure: A prospective observational multi-center study / Cattin, L; Ferrari, F; Mongodi, S; Pariani, E; Bettini, G; Daverio, F; Donadello, K; Polati, E; Mojoli, F; Danzi, V; De Rosa, S. - In: MEDICINA INTENSIVA. - ISSN 2173-5727. - 2023, 47:(2023), pp. 131-139. [10.1016/j.medine.2022.08.005]

Airways management in SARS-COV-2 acute respiratory failure: A prospective observational multi-center study

Donadello, K;De Rosa, S
2023-01-01

Abstract

Objective: 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. Setting: Tertiary care medical hospitals, dual-centre study performed in Northern Italy from November 2020 to May 2021. Patients: Adult patients with positive SARS-CoV-2 PCR test, admitted for respiratory failure and need of advanced invasive airways management. Interventions: Endotracheal Intubation Adverse Events. Main variables of interests: 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. Results: 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. Conclusion: In this study of intubation practices in critically ill patients with COVID-19, major adverse peri-intubation events were frequent. Clinical trial registration: www. Clinicaltrials: gov identifier: NCT04909476.
2023
Cattin, L; Ferrari, F; Mongodi, S; Pariani, E; Bettini, G; Daverio, F; Donadello, K; Polati, E; Mojoli, F; Danzi, V; De Rosa, S
Airways management in SARS-COV-2 acute respiratory failure: A prospective observational multi-center study / Cattin, L; Ferrari, F; Mongodi, S; Pariani, E; Bettini, G; Daverio, F; Donadello, K; Polati, E; Mojoli, F; Danzi, V; De Rosa, S. - In: MEDICINA INTENSIVA. - ISSN 2173-5727. - 2023, 47:(2023), pp. 131-139. [10.1016/j.medine.2022.08.005]
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