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01.02.2010 | Original

An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multiple-center study

verfasst von: Samir Jaber, Boris Jung, Philippe Corne, Mustapha Sebbane, Laurent Muller, Gerald Chanques, Daniel Verzilli, Olivier Jonquet, Jean-Jacques Eledjam, Jean-Yves Lefrant

Erschienen in: Intensive Care Medicine | Ausgabe 2/2010

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Abstract

Objective

To determined whether the implementation of an intubation management protocol leads to the reduction of intubation-related complications in the intensive care unit (ICU).

Design

Two-phase, prospective, multicenter controlled study.

Setting

Three medical-surgical ICUs in two university hospitals.

Patients

Two hundred three consecutive ICU patients required 244 intubations.

Interventions

All intubations performed during two consecutive phases (a 6-month quality control phase followed by a 6-month intervention phase based on the implementation of an ICU intubation bundle management protocol) were evaluated. The ten bundle components were: preoxygenation with noninvasive positive pressure ventilation, presence of two operators, rapid sequence induction, cricoid pressure, capnography, protective ventilation, fluid loading, preparation and early administration of sedation and vasopressor use if needed.

Measurements and main results

The primary end points were the incidence of life-threatening complications occurring within 60 min after intubation (cardiac arrest or death, severe cardiovascular collapse and hypoxemia). Other complications (mild to moderate) were also evaluated. Baseline characteristics, including demographic data and reason for intubation (mainly acute respiratory failure), were similar in the two phases. The intubation procedure in the intervention phase (n = 121) was associated with significant decreases in both life-threatening complications (21 vs. 34%, p = 0.03) and other complications (9 vs. 21%, p = 0.01) compared to the control phase (n = 123).

Conclusions

The implementation of an intubation management protocol can reduce immediate severe life-threatening complications associated with intubation of ICU patients.

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Titel: An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multiple-center study
verfasst von: Samir Jaber
Boris Jung
Philippe Corne
Mustapha Sebbane
Laurent Muller
Gerald Chanques
Daniel Verzilli
Olivier Jonquet
Jean-Jacques Eledjam
Jean-Yves Lefrant
Publikationsdatum: 01.02.2010
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 2/2010
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1717-8

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An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multiple-center study