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Incidence and factors associated with cardiac arrest complicating emergency airway management.

Abstract：

OBJECTIVE:Cardiac arrest (CA) is a rare but recognized complication of emergency airway management. Our aim was to measure the incidence of peri-intubation CA during emergency intubation and identify factors associated with this complication. METHODS:Retrospective cohort study of emergency endotracheal intubations performed in a large, urban emergency department over a one-year period. Patients were included if they were >18 years old and not in CA prior to intubation. Multiple logistic regression modeling was used to define factors independently associated with CA. RESULTS:A total 542 patients underwent emergency intubation during the study period and 410 met inclusion criteria for this study. CA occurred in 17/410 (4.2%) at a median of 6 min post-intubation. Nearly two-thirds of CA events occurred within 10 min of drug induction; early peri-intubation CA rate 2.4% (95% CI: 1.3-4.5%). Pulseless electrical activity was the initial rhythm in the majority of cases. More than half of CA events were successfully resuscitated but CA was associated with increased odds of hospital death (OR 14.8; 95% CI: 4.2-52). Pre-intubation hemodynamic and oximetry variables were associated with CA. CA was more common in patients experiencing pre intubation hypotension (12% vs 3%; p<0.002). Pre RSI shock index (SI) and weight were independently associated with CA. CONCLUSIONS:In this series, 1 in 25 emergency intubations was associated with the complication of CA. Peri-intubation CA is associated with increased mortality. Pre-intubation patient characteristics are associated with this complication.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Heffner AC,Swords DS,Neale MN,Jones AE

doi

10.1016/j.resuscitation.2013.07.022

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

1500-4

issue

11

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(13)00391-2

journal_volume

84

pub_type

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