Sun Mingyang, Zhang Jiaqiang, Zhang Weijia, Li Ningtao, Zuo Mingzhang, Qin Lei, Wu Szu-Yuan
Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou, Henan, China.
Department of Anesthesiology, Beijing Hospital, National Center of Gerontology Beijing, China.
Am J Transl Res. 2021 Apr 15;13(4):1915-1927. eCollection 2021.
In this study, we estimated the predictive factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in anesthesiologists performing endotracheal intubation in patients with confirmed SARS-CoV-2.
We analyzed data from a survey conducted by the Chinese Society of Anesthesiology Task Force on Airway Management on endotracheal intubation in 98 patients with SARS-CoV-2 confirmed through nucleic acid testing and chest computed tomography. The multivariate logistic model with stepwise selection was used for selecting the predictive factors significantly associated with SARS-CoV-2 infection in the corresponding anesthesiologists.
SARS-CoV-2 prevalence in the corresponding anesthesiologists was 20.41% after intubation in patients with SARS-CoV-2. Univariate analysis indicated that intubation for elective treatment, intubation in an operating room or isolation ward, and routine rapid induction with continuous positive-pressure ventilation (PPV) for intubation were associated with a lower SARS-CoV-2 risk in the anesthesiologists. Multivariate analysis revealed that intubation for elective treatment was associated with a significantly decreased SARS-CoV-2 risk (adjusted odds ratio [aOR] = 0.28, 95% confidence interval [CI]: 0.14-0.68, < 0.0001), and coughing by patients during endotracheal intubation was associated with a significantly increased SARS-CoV-2 risk (aOR = 1.70, 95% CI: 1.39-2.97, = 0.0404) in the anesthesiologists.
Endotracheal intubation for elective treatments, intubation in an operating room or isolation ward, and routine rapid induction with continuous PPV for patients with confirmed SARS-CoV-2 are associated with a lower risk of SARS-CoV-2 transmission in practicing anesthesiologists, and coughing by patients during intubation increases the risk.
在本研究中，我们评估了在为确诊严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者进行气管插管的麻醉医生中，SARS-CoV-2传播的预测因素。
我们分析了中国麻醉学会气道管理特别工作组对98例经核酸检测和胸部计算机断层扫描确诊为SARS-CoV-2的患者进行气管插管情况的调查数据。采用逐步选择的多变量逻辑模型来选择与相应麻醉医生感染SARS-CoV-2显著相关的预测因素。
在为SARS-CoV-2患者插管后，相应麻醉医生中SARS-CoV-2的感染率为20.41%。单因素分析表明，择期治疗插管、在手术室或隔离病房插管以及常规快速诱导并持续正压通气（PPV）进行插管与麻醉医生感染SARS-CoV-2的风险较低相关。多变量分析显示，择期治疗插管与SARS-CoV-2风险显著降低相关（调整后的优势比[aOR]=0.28，95%置信区间[CI]：0.14-0.68，P<0.0001），而气管插管期间患者咳嗽与麻醉医生感染SARS-CoV-2的风险显著增加相关（aOR=1.70，95%CI：1.39-2.97，P=0.0404）。
为确诊SARS-CoV-2的患者进行择期治疗插管、在手术室或隔离病房插管以及常规快速诱导并持续PPV与执业麻醉医生感染SARS-CoV-2的风险较低相关，而插管期间患者咳嗽会增加感染风险。
