Phillips Luke, Orford Neil, Ragg Michael
Department of Emergency Medicine, Barwon Health, Geelong, Victoria, Australia; Intensive Care Unit, Barwon Health, Geelong, Victoria, Australia; Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia.
Emerg Med Australas. 2014 Aug;26(4):368-75. doi: 10.1111/1742-6723.12257. Epub 2014 Jun 16.
The present study aimed to describe the characteristics and outcomes of intubation occurring in the ICU and ED of an Australian tertiary teaching hospital.
This was a prospective observational study of intubation practice across the Geelong Hospital over a 6 month period from 1 August 2012 to 31 January 2013. Data were entered by the intubating team through an online data collection form.
There were 119 patients intubated and 134 attempts at intubation in the ED and ICU over a 6 month period. The first-pass success rate was 104/119 (87.4%), and all but a single patient was intubated by the second attempt. Propofol, fentanyl, midazolam and suxamethonium were the most common drugs used in rapid sequence induction. AEs were reported in 44/134 (32.8%) of intubation attempts, with transient hypoxia and hypotension being the most common. A significant adverse outcome, namely aspiration pneumonitis, occurred in one patient. There were no peri-intubation deaths.
The majority of airways are managed by ICU and ED consultants and trainees, with success rates and AE rates comparable with other published studies.
本研究旨在描述澳大利亚一家三级教学医院重症监护病房（ICU）和急诊科（ED）内插管操作的特点及结果。
这是一项对2012年8月1日至2013年1月31日期间吉朗医院6个月内插管操作的前瞻性观察研究。数据由插管团队通过在线数据收集表录入。
在6个月期间，急诊科和重症监护病房有119例患者接受插管，共进行了134次插管尝试。首次插管成功率为104/119（87.4%），除1例患者外，其余患者均在第二次尝试时成功插管。丙泊酚、芬太尼、咪达唑仑和琥珀胆碱是快速序贯诱导中最常用的药物。在134次插管尝试中有44次（32.8%）报告了不良事件，其中短暂性低氧血症和低血压最为常见。1例患者出现了严重不良后果，即吸入性肺炎。插管期间无死亡病例。
大多数气道管理由重症监护病房和急诊科的顾问医生及实习医生进行，成功率和不良事件发生率与其他已发表研究相当。
