Critical incidents related to invasive mechanical ventilation in the ICU: preliminary descriptive study

Auriant, I.; Reignier, Jean; Pibarot, Marie-Laure; Bachat, S; Tenaillon, Alain; Raphaël, Jean Claude

doi:10.1007/s00134-002-1251-4

Cited by 27 publications

(10 citation statements)

References 12 publications

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“…The CVC rate may be dependent on the definition of CVC, particularly the level and duration of hypotension. Based on previous studies, we arbitrarily defined CVC as an arterial systolic blood pressure ≤65 mmHg recorded at least once and/or ≤90 mmHg lasting ≥30 minutes despite vascular loading with 500–1000 mL of crystalloid and/or colloid solutions and/or necessitating introduction of vasoactive drugs [ 1 , 18 , 19 ]. Mortality in the ICU was not related to hypotension after intubation, regardless of its definition and severity [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study

Parratte¹,

Jong

Delmas³

et al. 2015

Crit Care

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IntroductionSevere cardiovascular collapse (CVC) is a life-threatening complication after emergency endotracheal intubation (ETI) in the ICU. Many factors may interact with hemodynamic conditions during ETI, but no study to date has focused on factors associated with severe CVC occurrence. This study assessed the incidence of severe CVC after ETI in the ICU and analyzed the factors predictive of severe CVC.MethodsThis was a secondary analysis of a prospective multicenter study of 1,400 consecutive intubations at 42 ICUs. The incidence of severe CVC was assessed in patients who were hemodynamically stable (mean arterial blood pressure >65 mmHg without vasoactive drugs) before intubation, and the factors predictive of severe CVC were determined by multivariate analysis based on patient and procedure characteristics.ResultsSevere CVC occurred following 264 of 885 (29.8 %) intubation procedures. A two-step multivariate analysis showed that independent risk factors for CVC included simple acute physiologic score II regardless of age (odds ratio (OR) 1.02, p < 0.001), age 60–75 years (OR 1.96, p < 0.002 versus <60 years) and >75 years (OR 2.81, p < 0.001 versus <60 years), acute respiratory failure as a reason for intubation (OR 1.51, p = 0.04), first intubation in the ICU (OR 1.61, p = 0.02), noninvasive ventilation as a preoxygenation method (OR 1.54, p = 0.03) and inspired oxygen concentration >70 % after intubation (OR 1.91, p = 0.001). Comatose patients who required ETI were less likely to develop CVC during intubation (OR 0.48, p = 0.004).ConclusionsCVC is a frequent complication, especially in old and severely ill patients intubated for acute respiratory failure in the ICU. Specific bundles to prevent CVC may reduce morbidity and mortality related to intubation of these high-risk, critically ill patients.Trial registrationclinicaltrials.gov NCT01532063; registered 8 February 2012.

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Section: Discussionmentioning

confidence: 99%

Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study

Parratte¹,

Jong

Delmas³

et al. 2015

Crit Care

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“…In addition, when invasive ventilation is initiated to manage acute respiratory failure, the underlying lung disease (i.e., limited alveolar volume and enhanced shunt fraction) limits per se the efficiency of preoxygenation. As a result, hemoglobin desaturation is a well-known complication in this population (2,4,8,20,23,24). In our study, the incidence of oxyhemoglobin desaturation below 80% was observed in 14 among 53 studied patients (Figure 4).…”

Section: Preoxygenation In Critically Ill Patientsmentioning

confidence: 99%

Noninvasive Ventilation Improves Preoxygenation before Intubation of Hypoxic Patients

Baillard

Fosse

Sebbane

et al. 2006

Am J Respir Crit Care Med

389

220

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“…Mechanical ventilation has been associated with adverse events in 69% of ventilated patients. 24 Pneumothorax as a consequence of barotrauma or as a complication from a procedure occurs in 1.5% of patients in the ICU and has been associated with an increased risk of death. 25 Likewise, the support devices required in the care of patients in the ICU can be dislodged causing harm.…”

Section: Event Detectionmentioning

confidence: 99%

Adverse Event Reporting and Quality Improvement in the Intensive Care Unit

Heavner

Siner

2015

Clinics in Chest Medicine

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Critical incidents related to invasive mechanical ventilation in the ICU: preliminary descriptive study

Abstract: Use of our reporting method to create a CI database in a multicenter study including ICUs with varying recruitment patterns may help to identify markers suitable for routine continuous use as part of a quality-assurance program.

Cited by 27 publications

References 12 publications

Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study

Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study

Noninvasive Ventilation Improves Preoxygenation before Intubation of Hypoxic Patients

Adverse Event Reporting and Quality Improvement in the Intensive Care Unit

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