Division of Pulmonary Medicine, Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea
Copyright © 2019 The Korean Society of Critical Care Medicine
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Characteristics | PICA (n=15) | Non-PICA (n=347) | P-value |
---|---|---|---|
No. of intubation attempts | 0.03 | ||
1 | 8 (53.3) | 309 (89.0) | |
2 | 5 (33.3) | 37 (10.7) | |
≥3 | 2 (13.3) | 1 (0.3) | |
Intubation time (from induction to tube insertion, min) | 3.5 (1.2–5.9) | 2.1 (1.1–3.2) | <0.01 |
Procedure time of day | <0.01 | ||
Daytime (7:00 AM to 10:59 PM) | 4 (26.7) | 289 (83.3) | |
Nighttime (11:00 PM to 6:59 AM) | 11 (73.3) | 58 (16.7) | |
Type of sedative agents | 0.67 | ||
Midazolam | 10 (66.7) | 302 (87.0) | |
Ketamine | 3 (20.0) | 39 (11.3) | |
Others or multiple | 2 (13.3) | 6 (1.7) | |
NMBA use for RSI | 9 (60.0) | 135 (38.9) | 0.02 |
Use of succinylcholine | 6 (40.0) | 50 (14.4) | <0.01 |
Pre-ETI vital sign | |||
SBP (mm Hg) | 118.6±30.5 | 125.2±27.9 | 0.41 |
DBP (mm Hg) | 67.2±22.5 | 68.5±21.3 | 0.72 |
HR (/min) | 112.4±25.5 | 102.9±23.9 | 0.08 |
Shock indexa | 0.95±0.32 | 0.80±0.25 | 0.04 |
Intubation-related shock indexb | 3.3 (1.1–5.6) | 1.7 (0.9–2.6) | <0.01 |
Pre-ETI vasopressor use | 10 (66.7) | 31 (8.9) | <0.01 |
Values are presented as number (%), median (interquartile range), or mean±standard deviation.
PICA: peri-intubation cardiac arrest; NMBA: neuromuscular blocking agent; RSI: rapid sequence intubation; ETI: endotracheal intubation; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate.
aShock index=HR/SBP;
bIntubation-related shock index=shock index×intubation time.
Characteristics | PICA (n=15) | OTICA (n=402) | P-value |
---|---|---|---|
Age (yr) | 60.1±18.9 | 64.6±19.1 | 0.06 |
ROSC | 11 (73.3) | 332 (82.6) | 0.49 |
ICU LOS (day) | 20.3±6.9 | 23.9±5.9 | 0.66 |
Hospital LOS (day) | 43.6±12.2 | 45.1±13.9 | 0.72 |
Survival to hospital discharge | 8 (53.3) | 284 (70.6) | 0.08 |
Initial rhythm of arrest | 0.24 | ||
PEA | 9 (60.0) | 299 (74.4) | |
VT/VF | 3 (20.0) | 66 (16.4) | |
Asystole | 1 (6.7) | 21 (5.2) | |
AF | 1 (6.7) | 11 (2.7) | |
Uncertain | 1 (6.7) | 5 (1.2) | |
Neurologic outcomea at hospital discharge | 0.12 | ||
Good (CPC score 1 or 2) | 8 (53.3) | 270 (67.2) | |
Poor (CPC score 3, 4, or 5) | 7 (46.7) | 14 (13.7) |
Values are presented as mean±standard deviation or number (%).
PICA: peri-intubation cardiac arrest; OTICA: other types of inpatient cardiac arrest; ROSC: return of spontaneous circulation; ICU: intensive care unit; LOS: length of stay; PEA: pulseless electrical activity; VT: ventricular tachycardia; VF: ventricular fibrillation; AF: atrial fibrillation; CPC: cerebral performance category.
aPatients who died are not included in this category.
Characteristics | PICA (n=15) | Non-PICA (n=347) | P-value |
---|---|---|---|
Age (yr) | 60.1±18.9 | 58.6±19.1 | 0.76 |
Male sex | 8 (53.3) | 225 (64.8) | 0.12 |
BMI (kg/m2) | 21.6±4.1 | 22.0±4.0 | 0.83 |
Comorbidity | |||
COPD | 1 (6.7) | 46 (13.3) | 0.72 |
Congestive heart failure | 2 (13.3) | 26 (7.5) | 0.32 |
MI | 3 (20.0) | 40 (11.5) | 0.40 |
Stroke | 7 (46.7) | 172 (49.6) | 0.85 |
CKD | 4 (26.7) | 37 (10.7) | 0.09 |
Liver cirrhosis | 2 (13.3) | 20 (5.8) | 0.25 |
SOFA score | 8.0 (3.3–12.7) | 7.4 (3.6–11.2) | 0.24 |
Reasons for intubation | 0.15 | ||
Acute respiratory failure | 7 (46.7) | 275 (79.3) | |
Altered mental status | 3 (20.0) | 59 (17.0) | |
Shock | 2 (13.3) | 10 (2.9) | |
Others | 3 (20.0) | 3 (0.9) |
Characteristics | PICA (n=15) | Non-PICA (n=347) | P-value |
---|---|---|---|
No. of intubation attempts | 0.03 | ||
1 | 8 (53.3) | 309 (89.0) | |
2 | 5 (33.3) | 37 (10.7) | |
≥3 | 2 (13.3) | 1 (0.3) | |
Intubation time (from induction to tube insertion, min) | 3.5 (1.2–5.9) | 2.1 (1.1–3.2) | <0.01 |
Procedure time of day | <0.01 | ||
Daytime (7:00 AM to 10:59 PM) | 4 (26.7) | 289 (83.3) | |
Nighttime (11:00 PM to 6:59 AM) | 11 (73.3) | 58 (16.7) | |
Type of sedative agents | 0.67 | ||
Midazolam | 10 (66.7) | 302 (87.0) | |
Ketamine | 3 (20.0) | 39 (11.3) | |
Others or multiple | 2 (13.3) | 6 (1.7) | |
NMBA use for RSI | 9 (60.0) | 135 (38.9) | 0.02 |
Use of succinylcholine | 6 (40.0) | 50 (14.4) | <0.01 |
Pre-ETI vital sign | |||
SBP (mm Hg) | 118.6±30.5 | 125.2±27.9 | 0.41 |
DBP (mm Hg) | 67.2±22.5 | 68.5±21.3 | 0.72 |
HR (/min) | 112.4±25.5 | 102.9±23.9 | 0.08 |
Shock index |
0.95±0.32 | 0.80±0.25 | 0.04 |
Intubation-related shock index |
3.3 (1.1–5.6) | 1.7 (0.9–2.6) | <0.01 |
Pre-ETI vasopressor use | 10 (66.7) | 31 (8.9) | <0.01 |
Variable | Univariable |
Multivariable |
||
---|---|---|---|---|
OR (95% CI) | P-value | OR (95% CI) | P-value | |
Age | 0.97 (0.94–1.02) | 0.579 | ||
SOFA score | 0.89 (0.77–1.06) | 0.151 | ||
Number of intubation attempts | 4.67 (2.35–7.22) | 0.014 | 3.10 (1.12–7.86) | 0.026 |
Nighttime procedure | 3.21 (2.97–4.01) | 0.033 | ||
NMBA use for RSI | 2.34 (1.76–3.22) | 0.026 | 1.21 (1.08–3.15) | 0.035 |
Use of succinylcholine | 4.50 (1.45–7.20) | <0.001 | 3.45 (1.20–5.49) | 0.005 |
Shock index | 1.91 (1.00–2.52) | 0.043 | ||
Intubation-related shock index | 6.39 (2.17–12.44) | <0.001 | 4.06 (1.78–12.11) | 0.002 |
Pre-ETI vasopressor use | 5.67 (3.27–8.12) | <0.001 | 2.69 (1.15–7.42) | 0.012 |
Characteristics | PICA (n=15) | OTICA (n=402) | P-value |
---|---|---|---|
Age (yr) | 60.1±18.9 | 64.6±19.1 | 0.06 |
ROSC | 11 (73.3) | 332 (82.6) | 0.49 |
ICU LOS (day) | 20.3±6.9 | 23.9±5.9 | 0.66 |
Hospital LOS (day) | 43.6±12.2 | 45.1±13.9 | 0.72 |
Survival to hospital discharge | 8 (53.3) | 284 (70.6) | 0.08 |
Initial rhythm of arrest | 0.24 | ||
PEA | 9 (60.0) | 299 (74.4) | |
VT/VF | 3 (20.0) | 66 (16.4) | |
Asystole | 1 (6.7) | 21 (5.2) | |
AF | 1 (6.7) | 11 (2.7) | |
Uncertain | 1 (6.7) | 5 (1.2) | |
Neurologic outcome |
0.12 | ||
Good (CPC score 1 or 2) | 8 (53.3) | 270 (67.2) | |
Poor (CPC score 3, 4, or 5) | 7 (46.7) | 14 (13.7) |
Values are presented as mean±standard deviation, number (%), or median (interquartile range). PICA: peri-intubation cardiac arrest; BMI: body mass index; COPD: chronic obstructive pulmonary disease; MI: myocardial infarction; CKD: chronic kidney disease; SOFA: Sequential Organ Failure Assessment.
Values are presented as number (%), median (interquartile range), or mean±standard deviation. PICA: peri-intubation cardiac arrest; NMBA: neuromuscular blocking agent; RSI: rapid sequence intubation; ETI: endotracheal intubation; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate. Shock index=HR/SBP; Intubation-related shock index=shock index×intubation time.
PICA: peri-intubation cardiac arrest; OR: odds ratio; CI: confidence interval; SOFA: Sequential Organ Failure Assessment; NMBA: neuromuscular blocking agent; RSI: rapid sequential intubation; ETI: endotracheal intubation.
Values are presented as mean±standard deviation or number (%). PICA: peri-intubation cardiac arrest; OTICA: other types of inpatient cardiac arrest; ROSC: return of spontaneous circulation; ICU: intensive care unit; LOS: length of stay; PEA: pulseless electrical activity; VT: ventricular tachycardia; VF: ventricular fibrillation; AF: atrial fibrillation; CPC: cerebral performance category. Patients who died are not included in this category.