Prospective observational study of the endotracheal intubation complications in Emergency Department

Abstract

Endotracheal intubation is the gold standard intervention for emergency airway management. Complications related to endotracheal intubation are numerous and frequent. Complications were identified as being related to endotracheal intubation in our study: hypoxia, hypotension, dysrhythmia, cardiac arrest, hypertension, tachycardia, bradycardia, regurgitation and aspiration of stomach contents, endobronchial intubation, and incorrect positioning of the endotracheal tube in either the esophagus or hypopharynx. The study included 186 patients that were over 18 and intubated. The complication rate associated with endotracheal intubation was found to be over 50%. Patients included in our prospective, observational study were all initially evaluated in our ED. A survey was filled out at a time as soon as possible after intubation to record the personnel in charge of intubation, details of the procedure, and hemodynamic changes and complications. Our study found that the following factors were associated with increased rates of complication in intubated patients: history of acute renal failure, history of cancer, GCS < 8, midazolam use during intubation, history of trauma, crash intubation, history of shock, history of cardiac arrest, resident with <1 year of experience carrying out the intubation, residents with 2+ years of experience and specialists carrying out the intubation, history of respiratory failure, and patient age <65. To better understand which patients were likely to be affected by complications associated with intubation, as well as to understand which precautions to take, this study aims to investigate the aggravating factors and complication rates of endotracheal intubation.