Acute and Critical Care

Original Articles

CPR/Resuscitation
Risk factors associated with inpatient cardiac arrest during emergency endotracheal intubation at general wards: Chul Park; Acute Crit Care. 2019;34(3):212-218. Published online August 31, 2019; DOI: https://doi.org/10.4266/acc.2019.00598; Correction in: Acute Crit Care 2020;35(3):228

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Background
Peri-intubation cardiac arrest (PICA) following emergent endotracheal intubation (ETI) is a rare, however, potentially preventable type of cardiac arrest. Limited published data have described factors associated with inpatient PICA and patient outcomes. The aim of this study was to identify risk factors associated with PICA among hospitalized patients emergently intubated at a general ward as compared to non-PICA inpatients. In addition, we identified a difference of clinical outcomes in patients between PICA and other types of inpatient cardiac arrest (OTICA).
Methods
We conducted a retrospective observational study of patients at two institutions between January 2016 to December 2017. PICA was defined in patients emergently intubated who experienced cardiac arrest within 20 minutes after ETI. The non-PICA group consisted of inpatients emergently intubated without cardiac arrest. Risk factors for PICA were identified through univariate and multivariate logistic regression analysis. Clinical outcomes were compared between PICA and OTICA.
Results
Fifteen episodes of PICA occurred during the study period, accounting for 3.6% of all inpatient arrests. Intubation-related shock index, number of intubation attempts, pre-ETI vasopressor use, and neuromuscular blocking agent (NMBA) use, especially succinylcholine, were independently associated with PICA. Clinical outcomes of intensive care unit and hospital length of stay, survival to discharge, and neurologic outcome at hospital discharge were not significantly different between PICA and OTICA.
Conclusions
We identified four independent risk factors for PICA, and preintubation hemodynamic stabilization and avoidance of NMBA were possibly correlated with a decreased PICA risk. Clinical outcomes of PICA were similar to those of OTICA.

Citations

Citations to this article as recorded by

Risk factors for peri-intubation cardiac arrest: A systematic review and meta-analysis
Ting-Hao Yang, Shih-Chieh Shao, Yi-Chih Lee, Chien-Han Hsiao, Chieh-Ching Yen
Biomedical Journal.2024; 47(3): 100656. CrossRef
Patient Safety in Anesthesiology: Progress, Challenges, and Prospects
Wafaa Harfaoui, Mustapha Alilou, Ahmed Rhassane El Adib, Saad Zidouh, Aziz Zentar, Brahim Lekehal, Lahcen Belyamani, Majdouline Obtel
Cureus.2024;[Epub] CrossRef
Reverse shock index (RSI) as a predictor of post-intubation cardiac arrest (PICA)
Mehdi Torabi, Ghazal Soleimani Mahani, Moghaddameh Mirzaee
International Journal of Emergency Medicine.2023;[Epub] CrossRef
Incidence and factors associated with out-of-hospital peri-intubation cardiac arrest: a secondary analysis of the CURASMUR trial
Cédric Gil-Jardiné, Patricia Jabre, Frederic Adnet, Thomas Nicol, Patrick Ecollan, Bertrand Guihard, Cyril Ferdynus, Valery Bocquet, Xavier Combes
Internal and Emergency Medicine.2022; 17(2): 611. CrossRef
Risk factors associated with peri-intubation cardiac arrest in the emergency department
Ting-Hao Yang, Kuan-Fu Chen, Shi-Ying Gao, Chih-Chuan Lin
The American Journal of Emergency Medicine.2022; 58: 229. CrossRef
Comparison of video-stylet and conventional laryngoscope for endotracheal intubation in adults with cervical spine immobilization: A PRISMA-compliant meta-analysis
I-Wen Chen, Yu-Yu Li, Kuo-Chuan Hung, Ying-Jen Chang, Jen-Yin Chen, Ming-Chung Lin, Kuei-Fen Wang, Chien-Ming Lin, Ping-Wen Huang, Cheuk-Kwan Sun
Medicine.2022; 101(33): e30032. CrossRef
Peri-Intubation Cardiorespiratory Arrest Risk in Pediatric Patients: A Systematic Review
Rohit S. Loomba, Riddhi Patel, Elizabeth Kunnel, Enrique G. Villarreal, Juan S. Farias, Saul Flores
Journal of Pediatric Intensive Care.2022;[Epub] CrossRef
Comparison of Suction Rates Between a Standard Yankauer, a Commercial Large-Bore Suction Device, and a Makeshift Large-Bore Suction Device
Dhimitri A. Nikolla, Briana King, Andrew Heslin, Jestin N. Carlson
The Journal of Emergency Medicine.2021; 61(3): 265. CrossRef
Emergency Airway Management Outside the Operating Room: Current Evidence and Management Strategies
Kunal Karamchandani, Jonathan Wheelwright, Ae Lim Yang, Nathaniel D. Westphal, Ashish K. Khanna, Sheila N. Myatra
Anesthesia & Analgesia.2021; 133(3): 648. CrossRef
Further Validation of a Novel Acute Myocardial Infarction Risk Stratification (nARS) System for Patients with Acute Myocardial Infarction
Shinnosuke Sawano, Kenichi Sakakura, Kei Yamamoto, Yousuke Taniguchi, Takunori Tsukui, Masaru Seguchi, Hiroshi Wada, Shin-ichi Momomura, Hideo Fujita
International Heart Journal.2020; 61(3): 463. CrossRef
Corrigendum to: Risk factors associated with inpatient cardiac arrest during emergency endotracheal intubation at general wards
Chul Park
Acute and Critical Care.2020; 35(3): 228. CrossRef

Multicenter Prospective Observational Study about the Usage Patterns of Sedatives, Analgesics and Neuromuscular Blocking Agents in the Patients Requiring More Than 72 Hours Mechanical Ventilation in Intensive Care Units of Korea: Hang Jea Jang, Seung Won Ra, Bum Jin Oh, Chae Man Lim, Younsuck Koh, Sang Bum Hong; Korean J Crit Care Med. 2009;24(3):145-151.; DOI: https://doi.org/10.4266/kjccm.2009.24.3.145

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Abstract PDF

BACKGROUND
To investigate the usage patterns of sedatives, analgesics and neuromuscular blocking agents (NMBAs) in patients requiring mechanical ventilation more than 72 hours in intensive care units (ICUs) of Korea.
METHODS
A total of 536 patients continuing mechanical ventilation more than 72 hours had been enrolled among the twenty-one ICUs of Korea from May 2003 to July 2003. Data about mechanical ventilation, the use of sedatives, analgesics, and NMBAs were prospectively collected for four weeks. We analyzed the patterns of using these drugs and effects on outcomes.
RESULTS
More than half of the patients (50.4%) received sedative drug alone. Most commonly used sedatives and analgesics were midazolam and morphine. NMBAs were administered in 41% of the patients. Volume controlled ventilation mode was associated with more frequent use of NMBAs. There were no significant differences in outcome variables among the usage patterns of sedatives, analgesics and NMBAs.
CONCLUSIONS
Our investigation shows that analgesics were much less frequently used in the intensive care units of Korea compared with the use of sedatives. And the use of NMBAs were quite a common.

Citations

Citations to this article as recorded by

Change in management and outcome of mechanical ventilation in Korea: a prospective observational study
Jae Kyeom Sim, Sang-Min Lee, Hyung Koo Kang, Kyung Chan Kim, Young Sam Kim, Yun Seong Kim, Won-Yeon Lee, Sunghoon Park, So Young Park, Ju-Hee Park, Yun Su Sim, Kwangha Lee, Yeon Joo Lee, Jin Hwa Lee, Heung Bum Lee, Chae-Man Lim, Won-Il Choi, Ji Young Hong
The Korean Journal of Internal Medicine.2022; 37(3): 618. CrossRef
Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission
Hye Ran Kwak, Jiyeon Kang
Korean Journal of Adult Nursing.2015; 27(3): 347. CrossRef
Clinical Demographics and Outcomes in Mechanically Ventilated Patients in Korean Intensive Care Units
Byeong-Ho Jeong, Gee Young Suh, Jin Young An, Moo Suk Park, Jin Hwa Lee, Myung-Goo Lee, Je Hyeong Kim, Yun Seong Kim, Hye Sook Choi, Kyung Chan Kim, Won-Yeon Lee, Younsuck Koh
Journal of Korean Medical Science.2014; 29(6): 864. CrossRef

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