• Byuk Sung Ko, Ryeok Ahn, Seung Mok Ryoo, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Kyoung Soo Lim, and Won Young Kim.
• Department of Emergency Medicine, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
• Am J Emerg Med. 2015 Nov 1;33(11):1642-5.

BackgroundEmergency endotracheal intubation-related cardiac arrest (CA) is not well documented. This study compares the clinical features and outcomes of intubation-related CA and other causes of inhospital CA.MethodsAll study patients were consecutive adults (≥18 years) who developed CA in the emergency department between January 2007 and December 2011. Emergent endotracheal intubation-related CA was defined as occurring within 20 minutes after successful intubation. Clinical variables were compared between patients with intubation-related CA and intubation-unrelated CA. The primary outcome was a good neurologic outcome defined as a Cerebral Performance Category score of 1 to 2. The secondary outcome was survival to hospital discharge.ResultsOf the 251 patients who developed CA, 41 were excluded due to trauma-related CA or "do-not-resuscitate" protocols, thereby leaving 210 patients. The prevalence of intubation-related CA was 23.3%, and the median duration between successful intubation and CA was 5.0 minutes (interquartile range, 2.0-9.5). Pulseless electrical activity was more commonly noted as the first arrest rhythm in the intubation-related CA group (75.5% vs 59.0%; P = .03) compared with patients with other causes of CA. However, the rates of good neurologic outcomes (14.3% vs 21.1%) and survival to discharge (34.7% vs 35.4%) were not significantly higher in intubation-related CA group (both P > .05).ConclusionEndotracheal intubation-related CA occurred higher than commonly recognized, and patient outcomes were not better than other causes of CA. These data highlight the importance of efforts to prevent intubation-related CA. However, further prospective larger study will be required to generalize this result.Copyright © 2015 Elsevier Inc. All rights reserved.

22 keywords...

hide…