Kuo-Chuan Hung1, Hsiu-Jung Lin2, Shao-Wei Hsieh3, Cheuk-Kwan Sun4. 1. Department of Anesthesiology, Chi Mei Medical Center, No. 901 ChungHwa Road, YungKung District, 71004, Tainan County, Taiwan, ROC. ed102605@gmail.com. 2. Department of Anesthesiology, E-DA Hospital, Kaohsiung, Taiwan, ROC. 3. Department of Anesthesiology, Beigang Hospital, China Medical University, Yunlin, Taiwan, ROC. 4. Department of Emergency Medicine, E-Da Hospital, School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan, ROC.
Abstract
BACKGROUND: The time in the day of intervention for physiological deterioration reportedly impacts patient outcomes. This study aimed at determining the impact of the time of ETI on hospital survival in critically ill patients. METHODS: Between January 2014 and December 2016, 151 patients who underwent emergency tracheal intubation (ETI) by the airway response team (ART) in the general wards of a tertiary referral center were retrospectively reviewed. Patients were divided into two groups based on the time of ETI (daytime group, 8:00 a.m.-4:00 p.m., n = 57, mean age 63.5 ± 14.1 years; nighttime group, 4:00 p.m.-8:00 a.m., n = 94, mean age 60.4 ± 14.9 years). Data regarding demographic information, comorbidities, trigger events for intubation, survival-to-discharge rates, acute physiology and chronic health evaluation II (APACHE II), ventilator-free days, and airway techniques were collected. RESULTS: There was no significant difference in sex, age, body mass index, APACHE II, or comorbidities between the two groups, except that a higher proportion of patients presented with arrhythmias (21.1 vs. 8.5%, p = 0.028) and received fiberoptic intubation (24.6 vs. 11.7%, p = 0.039) in the daytime group than in the nighttime group. The time of the ART arrival after call was also shorter in daytime than that in nighttime (6.1 ± 1.4 vs. 10.5 ± 3.2 min, respectively, p < 0.001). There were no differences in the survival-to-discharge rate (45.6 vs. 43.6%, p = 0.811), ventilator-free days, or trigger events between the two groups. CONCLUSIONS: Emergent tracheal intubation in the nighttime may not have negative impact on the survival-to-discharge rate compared with that performed in the daytime.
BACKGROUND: The time in the day of intervention for physiological deterioration reportedly impacts patient outcomes. This study aimed at determining the impact of the time of ETI on hospital survival in critically ill patients. METHODS: Between January 2014 and December 2016, 151 patients who underwent emergency tracheal intubation (ETI) by the airway response team (ART) in the general wards of a tertiary referral center were retrospectively reviewed. Patients were divided into two groups based on the time of ETI (daytime group, 8:00 a.m.-4:00 p.m., n = 57, mean age 63.5 ± 14.1 years; nighttime group, 4:00 p.m.-8:00 a.m., n = 94, mean age 60.4 ± 14.9 years). Data regarding demographic information, comorbidities, trigger events for intubation, survival-to-discharge rates, acute physiology and chronic health evaluation II (APACHE II), ventilator-free days, and airway techniques were collected. RESULTS: There was no significant difference in sex, age, body mass index, APACHE II, or comorbidities between the two groups, except that a higher proportion of patients presented with arrhythmias (21.1 vs. 8.5%, p = 0.028) and received fiberoptic intubation (24.6 vs. 11.7%, p = 0.039) in the daytime group than in the nighttime group. The time of the ART arrival after call was also shorter in daytime than that in nighttime (6.1 ± 1.4 vs. 10.5 ± 3.2 min, respectively, p < 0.001). There were no differences in the survival-to-discharge rate (45.6 vs. 43.6%, p = 0.811), ventilator-free days, or trigger events between the two groups. CONCLUSIONS: Emergent tracheal intubation in the nighttime may not have negative impact on the survival-to-discharge rate compared with that performed in the daytime.
Authors: Mohammad A Saleem; Hari Kannam; Wilbert S Aronow; Melvin B Weiss; Kumar Kalapatapu; Anthony L Pucillo; Craig E Monsen Journal: Am J Cardiol Date: 2004-03-15 Impact factor: 2.778
Authors: Emily J Robinson; Gary B Smith; Geraldine S Power; David A Harrison; Jerry Nolan; Jasmeet Soar; Ken Spearpoint; Carl Gwinnutt; Kathryn M Rowan Journal: BMJ Qual Saf Date: 2015-12-11 Impact factor: 7.035