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Vol. 42. Num. 9.December 2018
Pages e23-e28Pages 517-572
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Vol. 42. Num. 9.December 2018
Pages e23-e28Pages 517-572
Original
DOI: 10.1016/j.medine.2017.10.014
Are “off hours” intubations a risk factor for complications during intubation? A prospective, observational study
¿Tiene más complicaciones la intubación orotraqueal en las Unidades de Cuidados Críticos durante el periodo llamado off-hours? Estudio prospectivo y observacional
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M. Taboada
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manutabo@yahoo.es

Corresponding author.
, A. Calvo, P. Doldán, M. Ramas, D. Torres, M. González, A. Rodríguez, M. Lombardía, Cr. Fernandez, A. Baluja, P. Otero, J. Álvarez
Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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Tables (4)
Table 1. Demographic characteristics in the 2 groups of patients.
Table 2. Characteristics of intubation procedures on the 2 groups of patients.
Table 3. Difficulty during the intubation procedure in the 2 groups of patients.
Table 4. Frequency of complications during the intubation procedure in the two groups of patients.
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Abstract
Objective

To compare the complications and the difficulty of orotracheal intubation procedures performed in the Intensive Care Unit during the off-hours period and the on-hours period.

Design

A prospective, observational and non-interventional cohort study covering a period of 27 months was carried out. Working days between 8:00 a.m. and 7:59 p.m. were considered “on-hours”, while the remaining shifts were regarded as “off-hours”.

Scope

An 18-bed surgical in a Intensive Care Unit of a third-level hospital.

Patients

All orotracheal intubation patients admitted to the ICU from January 2015 to March 2017 were included. Patients were stratified into 2 groups according to whether intubation was performed on-hours or off-hours.

Interventions

Non-interventional study.

Variables of interest

The reason for intubation, time and day on which intubation was performed, degree of intubation difficulty (number of attempts, Cormack–Lehane laryngoscopic vision, need for accessory material) and complications during intubation.

Results

A total of 252 patients were intubated; of these, 132 were included in the on-hours group and 120 patients in the off-hours group. In the off-hours group we observed a greater percentage of urgent and emergent intubations compared to the on-hours group. However, no differences were found between the 2 groups in relation to the other variables studied.

Conclusions

During the off-hours period, orotracheal intubation was not associated to a greater number of complications or to greater difficulty of the technique in our Unit.

Keywords:
Orotracheal intubation
Intensive Care Unit
Critical care
Complications
Hypoxia
Hypotension
Resumen
Objetivo

Comparar las complicaciones y el grado de dificultad de la intubación orotraqueal realizada en una Unidad de Cuidados Críticos, durante el periodo off-hours (turno de noche y fines de semana) y el periodo on-hours (turno de día).

Diseño

Estudio de cohortes, prospectivo, observacional y no intervencionista, durante un periodo de 27 meses. Se consideró on-hours el periodo de entre las 8:00 a.m. y las 7:59 p.m. de los días laborales, y off-hours el resto de los turnos.

Ámbito

Una Unidad de Cuidados Críticos de 18 camas de un hospital clínico universitario de tercer nivel.

Pacientes

Se incluyó a todos los pacientes con intubación orotraqueal en la unidad desde enero de 2015 hasta marzo de 2017. Los pacientes se estratificaron en 2 grupos en función de si la intubación se realizaba en periodo on-hours u off-hours.

Intervenciones

Estudio no intervencionista.

Variables de interés

Motivo de intubación, hora y día en el que se realiza la intubación, grado de dificultad de intubación (número de intentos, visión laringoscópica Cormack-Lehane, necesidad de material complementario) y complicaciones durante la intubación.

Resultados

Se intubó a 252 pacientes, de los que 132 fueron incluidos en el grupo on-hours y 120 en el grupo off-hours. En el grupo off-hours observamos un mayor porcentaje de intubaciones urgentes o emergentes en comparación con el grupo on-hours. No encontramos diferencias entre los 2 grupos en el resto de las variables estudiadas.

Conclusiones

La intubación que se realiza en nuestra unidad durante el periodo off-hours no se ha podido asociar a un mayor número de complicaciones ni a una mayor dificultad de la técnica.

Palabras clave:
Intubación orotraqueal
Unidad de Cuidados Intensivos
Cuidados críticos
Complicaciones
Hipoxia
Hipotensión

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