Soh Mitsuhito, Hifumi Toru, Otani Norio, Maki Kenro, Hayashi Munehiro, Miyazaki Momoyo, Kobayashi Kentaro, Ageishi Ryo, Hatakeyama Junji, Kurihara Tomohiro, Ishimatsu Shinichi
Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.
Department of Emergency and Critical Care Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
Glob Health Med. 2022 Apr 30;4(2):116-121. doi: 10.35772/ghm.2021.01114.
Emergency physicians perform endotracheal intubations for patients with COVID-19. However, the trends in the intubation for COVID-19 patients in terms of success rate, complications, personal protective equipment (PPE) information, barrier enclosure use, and its transition have not been established. We conducted a retrospective study of COVID-19 cases that required tracheal intubation at four hospitals in the Tokyo metropolitan area between January 2020 and August 2021. The overall intubation success rate, operator experience, and infection control methods were investigated. We then compared the early and late phases of the pandemic for a period of 8 months each. A total of 211 cases met the inclusion criteria, and 133 were eligible for analysis. The intubation success rate increased from 85% to 94% from early to late phase, although the percentage of intubations performed by emergency medicine residents increased significantly in the late phase ( = 0.03). The percentage of light PPE use significantly increased from 65% to 91% from early to late phase ( < 0.01), whereas the percentage of barrier enclosure use significantly decreased from 26% to 0% ( < 0.01). Furthermore, the infection prevention methods during intubation became more simplified from early to late phase.
急诊医生为新冠肺炎患者进行气管插管。然而,新冠肺炎患者气管插管在成功率、并发症、个人防护装备(PPE)信息、屏障罩使用及其转变方面的趋势尚未明确。我们对2020年1月至2021年8月期间东京都市区四家医院需要气管插管的新冠肺炎病例进行了一项回顾性研究。调查了总体插管成功率、操作人员经验和感染控制方法。然后,我们对疫情的早期和晚期各8个月的时间段进行了比较。共有211例病例符合纳入标准,133例符合分析条件。从早期到晚期,插管成功率从85%提高到94%,尽管晚期急诊医学住院医师进行插管的比例显著增加(P = 0.03)。从早期到晚期,使用轻型PPE的比例从65%显著增加到91%(P < 0.01),而使用屏障罩的比例从26%显著下降到0%(P < 0.01)。此外,从早期到晚期,插管期间的感染预防方法变得更加简化。