EMERGENCY TRACHEAL INTUBATION IN THE POSTANESTHESIA CARE UNIT : PHYSICIAN ERROR OR PATIENT DISEASE ?

摘要: Inadequate airway maintenance has been a major factor in perioperative morbidity. To determine the incidence and etiology of emergency tracheal intubations postanesthesia care unit (PACU), we retrospectively reviewed 13,593 consecutive admissions to our PACU from October 1986 through 1988. Twenty-six patients (26/13,593 = 0.19%) required insertion an endotracheal tube while PACU. Seventy-seven percent (20/26) occurred within 1 h extubation and/or admission Intubation was more common at extremes age; 54% those intubated were than 60 yr old (P 0.003); 19% less 3 0.05). Twenty-three had undergone otolaryngologic procedures 0.008). Interestingly, 73% during months January June 0.016). Median scores lower for group 0.001). There no association between intubation gender 0.74), anesthetic technique 0.41), or agent 0.49). Of 26 intubations, 18 (69%) considered be directly related management. Despite extremely low heterogeneous admitted PACU, preventable anesthesia-related etiologic factors including excessive sedative effect, inappropriate fluid management, persistent muscle relaxant upper obstruction contributed majority these intubations.