AI Article Synopsis

  • The study aimed to identify factors linked to successful pediatric intubation on the first attempt in emergency departments (ED).
  • Researchers analyzed data from two large studies involving 293 children across 17 EDs, focusing on variables like age, use of rapid sequence intubation (RSI), and the experience of the intubator.
  • Results showed that being older (≥10 years), using RSI, and having an emergency physician perform the intubation significantly increased the likelihood of success on the first attempt.

Article Abstract

Introduction: The objective of this study was to investigate the factors associated with first-pass success in pediatric intubation in the emergency department (ED).

Methods: We analyzed the data from two multicenter prospective studies of ED intubation in 17 EDs between April 2010 and September 2014. The studies prospectively measured patient's age, sex, principal indication for intubation, methods (e.g., rapid sequence intubation [RSI]), devices, and intubator's level of training and specialty. To evaluate independent predictors of first-pass success, we fit logistic regression model with generalized estimating equations. In the sensitivity analysis, we repeated the analysis in children <10 years.

Results: A total of 293 children aged ≤18 years who underwent ED intubation were eligible for the analysis. The overall first-pass success rate was 60% (95%CI [54%-66%]). In the multivariable model, age ≥10 years (adjusted odds ratio [aOR], 2.45; 95% CI [1.23-4.87]), use of RSI (aOR, 2.17; 95% CI [1.31-3.57]), and intubation attempt by an emergency physician (aOR, 3.21; 95% CI [1.78-5.83]) were significantly associated with a higher chance of first-pass success. Likewise, in the sensitivity analysis, the use of RSI (aOR, 3.05; 95% CI [1.63-5.70]), and intubation attempt by an emergency physician (aOR, 4.08; 95% CI [1.92-8.63]) were significantly associated with a higher chance of first-pass success.

Conclusion: Based on two large multicenter prospective studies of ED airway management, we found that older age, use of RSI, and intubation by emergency physicians were the independent predictors of a higher chance of first-pass success in children. Our findings should facilitate investigations to develop optimal airway management strategies in critically-ill children in the ED.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786230PMC
http://dx.doi.org/10.5811/westjem.2016.1.28685DOI Listing

Publication Analysis

Top Keywords

first-pass success
12
factors associated
8
associated first-pass
8
success pediatric
8
pediatric intubation
8
intubation emergency
8
emergency department
8
intubation
5
department introduction
4
introduction objective
4

Similar Publications

Alzheimer's disease (ALZ) is a neurodegenerative disease that damages neuronal cells and causes decline in cognitive abilities. Administration of cholinesterase inhibitor compounds is the primary choice in the treatment of ALZ, one of which is rivastigmine (RVT). Several routes of administration of RVT are available, such as oral and transdermal.

View Article and Find Full Text PDF

Hyperdense Middle Cerebral Artery Sign as a Predictor of First-Pass Recanalization and Favorable Outcomes in Direct Thrombectomy Patients.

Clin Neuroradiol

December 2024

Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, 100070, Fengtai District, Beijing, China.

Background: The Hyperdense Middle Cerebral Artery Sign (HMCAS) is an early marker of acute MCA occlusion on non-contrast CT (NCCT), which has been linked with stroke type and thrombus composition.

Aims: To assess the prognostic value of HMCAS in M1 occlusion patients treated with endovascular thrombectomy and explore its predictive value across different patients.

Methods: Patients with M1 occlusion were selected from the ANGEL-ACT registry, which comprised 1793 individuals.

View Article and Find Full Text PDF

Randomized Study Comparing First-Line Dual Versus Single-Stent Retriever Technique: TWIN2WIN.

Stroke

December 2024

Stroke Research Group, Vall d'Hebron Research Institute, Barcelona, Universitat Autonoma de Barcelona, Spain (A.T., M.J., J.C., F.D., D.H., M.d.D., M. Rubiera, A.G.-T., F.R., M.O., M.R.-G., C.M., M. Ribo).

Background: The double-stent retriever (SR) technique has been described as an effective rescue technique when single-SR fails to induce recanalization. We aimed to assess the safety and efficacy of first-line double-SR in patients with stroke undergoing thrombectomy.

Methods: This was a multicenter, randomized, controlled, blinded adjudicated primary outcome study.

View Article and Find Full Text PDF

Background: Complete clot ingestion (CCI) is defined as full ingestion of the clot into the catheter or pump canister without any external clot remnants at the catheter tip. The aim of this study was to demonstrate that using the CCI metric in vitro, partially ingested ('corked') clots pose a higher risk of distal emboli given distal emboli may exist in the setting of Thrombolysis In Cerebral Infarction 3 (TICI 3) revascularization.

Methods: Thrombectomies using an in vitro synthetic clot analog were conducted across six catheters using the novel ALGO Smart Pump with Adaptive Pulsatile Aspiration (APA) (Von Vascular Inc, Sunrise, FL) and compared against the Penumbra static Engine Pump (Alameda, CA).

View Article and Find Full Text PDF

Background And Purpose: Mechanical thrombectomy (MT) has become the standard of care for treatment of acute ischemic stroke secondary to large vessel occlusion up to 24 h from the last known normal time. With ADAPT and SOLUMBRA techniques, classically, a large bore aspiration catheter is delivered over a microcatheter and microwire crossing the clot to perform thrombectomy. Recently, a novel macrowire (Colossus 035 in.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!

A PHP Error was encountered

Severity: Notice

Message: fwrite(): Write of 34 bytes failed with errno=28 No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 272

Backtrace:

A PHP Error was encountered

Severity: Warning

Message: session_write_close(): Failed to write session data using user defined save handler. (session.save_path: /var/lib/php/sessions)

Filename: Unknown

Line Number: 0

Backtrace: