当前位置： SCI文献检索 > CRITICAL CARE MEDICINE期刊下所有文献 > A National Emergency Airway Registry for children: landscape of tracheal intubation in 15 PICUs.

A National Emergency Airway Registry for children: landscape of tracheal intubation in 15 PICUs.

Abstract：

OBJECTIVES:To characterize the landscape of process of care and safety outcomes for tracheal intubation across pediatric intensive care units BACKGROUND:Procedural process of care and safety outcomes of tracheal intubation across pediatric intensive care units has not been described. We hypothesize that the novel National Emergency Airway Registry for Children registry is a feasible tool to capture tracheal intubation process of care and outcomes. DESIGN:Prospective, descriptive. SETTING:Fifteen academic PICUs in North America. PATIENTS:Critically ill children requiring tracheal intubation in PICUs. INTERVENTIONS:Tracheal intubation quality improvement data were prospectively collected for all initial tracheal intubation in 15 PICUs from July 2010 to December 2011 using the National Emergency Airway Registry for Children tool with explicit site-specific compliance plans and operational definitions including adverse tracheal intubation associated events. MEASUREMENT AND MAIN RESULTS:One thousand seven hundred fifteen tracheal intubation encounters were reported (averaging 1/3.4 days, or 1/86 bed days). Ninety-eight percent of primary tracheal intubation were successful; 86% were successful with less than or equal to two attempts. First attempt was by pediatric residents in 23%, pediatric critical care fellows in 41%, and critical care attending physicians in 13%: first attempt success rate was 62%, first provider success rate was 79%. The first method was oral intubation in 1,659 (98%) and nasal in 55 (2%). Direct laryngoscopy was used in 96%. Ninety percent of tracheal intubation were with cuffed tracheal tubes. Adverse tracheal intubation associated events were reported in 20% of intubations (n = 372), with severe tracheal intubation associated events in 6% (n = 115). Esophageal intubation with immediate recognition was the most common tracheal intubation associated events (n = 167, 9%). History of difficult airway, diagnostic category, unstable hemodynamics, and resident provider as first airway provider were associated with occurrence of tracheal intubation associated events. Severe tracheal intubation associated events were associated with diagnostic category and pre-existing unstable hemodynamics. Elective tracheal intubation status was associated with fewer severe tracheal intubation associated events. CONCLUSIONS:National Emergency Airway Registry for Children was feasible to characterize PICU tracheal intubation procedural process of care and safety outcomes. Self-reported adverse tracheal intubation associated events occurred frequently and were associated with patient, provider, and practice characteristics.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Nishisaki A,Turner DA,Brown CA 3rd,Walls RM,Nadkarni VM,National Emergency Airway Registry for Children (NEAR4KIDS).,Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network.

doi

10.1097/CCM.0b013e3182746736

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

874-85

issue

eissn

0090-3493

issn

1530-0293

journal_volume

pub_type

杂志文章

在线工具

A National Emergency Airway Registry for children: landscape of tracheal intubation in 15 PICUs.