التفاصيل البيبلوغرافية
| العنوان: |
High-risk criteria for the physiologically difficult paediatric airway: A multicenter, observational study to generate validity evidence. |
| المؤلفون: |
Dean, Preston1,2 (AUTHOR) preston.dean@cchmc.org, Geis, Gary1,2 (AUTHOR) gary.geis@cchmc.org, Hoehn, Erin F.1,3,4 (AUTHOR) erin.hoehn@uhhospitals.org, Lautz, Andrew J.2,5 (AUTHOR) andrew.lautz@cchmc.org, Edmunds, Katherine1,2 (AUTHOR) katherine.edmunds@cchmc.org, Shah, Ashish6 (AUTHOR) ashah@health.ucsd.edu, Zhang, Yin7 (AUTHOR) yin.zhang@cchmc.org, Frey, Mary1 (AUTHOR) mary.frey@cchmc.org, Boyd, Stephanie1 (AUTHOR) stephanie.boyd@cchmc.org, Nagler, Joshua8 (AUTHOR) joshua.nagler@childrens.harvard.edu, Miller, Kelsey A.8 (AUTHOR) kelsey.miller@childrens.harvard.edu, Neubrand, Tara L.1,9,10 (AUTHOR) tneubrand@salud.unm.edu, Cabrera, Natasha9 (AUTHOR), Kopp, Tara M.11 (AUTHOR) tara.kopp.1@louisville.edu, Wadih, Esper11 (AUTHOR) esper.wadih@louisville.edu, Kannikeswaran, Nirupama12 (AUTHOR) nkannike@dmc.org, VanDeWall, Audrey12 (AUTHOR) avandewa@dmc.org, Hewett Brumberg, Elizabeth K.3 (AUTHOR) elizabeth.hewett@chp.edu, Donoghue, Aaron13 (AUTHOR) donoghue@chop.edu, Palladino, Lauren13 (AUTHOR) palladinol@chop.edu |
| المصدر: |
Resuscitation. Sep2023, Vol. 190, pN.PAG-N.PAG. 1p. |
| مصطلحات موضوعية: |
*CHILD patients, *EXTRACORPOREAL membrane oxygenation, *HEART diseases, *CARDIAC arrest, *OXYGEN therapy, *LARYNGOSCOPES, *BRONCHOSCOPES |
| مستخلص: |
Single-center studies have identified risk factors for peri-intubation cardiac arrest in the emergency department (ED). The study objective was to generate validity evidence from a more diverse, multicenter cohort of patients. We completed a retrospective cohort study of 1200 paediatric patients who underwent tracheal intubation in eight academic paediatric EDs (150 per ED). The exposure variables were 6 previously studied high-risk criteria for peri-intubation arrest: (1) persistent hypoxemia despite supplemental oxygen, (2) persistent hypotension, (3) concern for cardiac dysfunction, (4) post-return of spontaneous circulation (ROSC), (5) severe metabolic acidosis (pH < 7.1), and (6) status asthmaticus. The primary outcome was peri-intubation cardiac arrest. Secondary outcomes included extracorporeal membrane oxygenation (ECMO) cannulation and in-hospital mortality. We compared all outcomes between patients that met one or more versus no high-risk criteria, using generalized linear mixed models. Of the 1,200 paediatric patients, 332 (27.7%) met at least one of 6 high-risk criteria. Of these, 29 (8.7%) suffered peri-intubation arrest compared to zero arrests in patients meeting none of the criteria. On adjusted analysis, meeting at least one high-risk criterion was associated with all 3 outcomes – peri-intubation arrest (AOR 75.7, 95% CI 9.7–592.6), ECMO (AOR 7.1, 95% CI 2.3–22.3) and mortality (AOR 3.4, 95% 1.9–6.2). Four of 6 criteria were independently associated with peri-intubation arrest: persistent hypoxemia despite supplemental oxygen, persistent hypotension, concern for cardiac dysfunction, and post-ROSC. In a multicenter study, we confirmed that meeting at least one high-risk criterion was associated with paediatric peri-intubation cardiac arrest and patient mortality. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |
