|
福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
A 医学部 = School of Medicine >
a10 学術雑誌論文等 = Journal Article >
このアイテムの引用には次の識別子を使用してください:
http://ir.fmu.ac.jp/dspace/handle/123456789/527
|
| タイトル: | Emergency endotracheal intubation-related adverse events in bronchial asthma exacerbation: can anesthesiologists attenuate the risk? |
| 著者: | Ono, Yuko
Kikuchi, Hiroaki
Hashimoto, Katsuhiko
Sasaki, Tetsu
Ishii, Jyunya
Tase, Choichiro
Shinohara, Kazuaki |
| 学内所属: | 救急医療学講座 |
| 誌名/書名: | Journal of anesthesia |
| 巻: | 29 |
| 号: | 5 |
| 開始ページ: | 678 |
| 終了ページ: | 685 |
| 発行日: | 2015年10月 |
| 抄録: | PURPOSE: Airway management in severe bronchial asthma exacerbation (BAE) carries very high risk and should be performed by experienced providers. However, no objective data are available on the association between the laryngoscopist's specialty and endotracheal intubation (ETI)-related adverse events in patients with severe bronchial asthma. In this paper, we compare emergency ETI-related adverse events in patients with severe BAE between anesthesiologists and other specialists. METHODS: This historical cohort study was conducted at a Japanese teaching hospital. We analyzed all BAE patients who underwent ETI in our emergency department from January 2002 to January 2014. Primary exposure was the specialty of the first laryngoscopist (anesthesiologist vs. other specialist). The primary outcome measure was the occurrence of an ETI-related adverse event, including severe bronchospasm after laryngoscopy, hypoxemia, regurgitation, unrecognized esophageal intubation, and ventricular tachycardia. RESULTS: Of 39 patients, 21 (53.8 %) were intubated by an anesthesiologist and 18 (46.2 %) by other specialists. Crude analysis revealed that ETI performed by an anesthesiologist was significantly associated with attenuated risk of ETI-related adverse events [odds ratio (OR) 0.090, 95 % confidence interval (CI) 0.020-0.41, p = 0.001]. The benefit of attenuated risk remained significant after adjusting for potential confounders, including Glasgow Coma Score, age, and use of a neuromuscular blocking agent (OR 0.058, 95 % CI 0.010-0.35, p = 0.0020). CONCLUSIONS: Anesthesiologist as first exposure was independently associated with attenuated risk of ETI-related adverse events in patients with severe BAE. The skill and knowledge of anesthesiologists should be applied to high-risk airway management whenever possible. |
| 出版者: | Springer |
| 本文の言語: | eng |
| このページのURI: | http://ir.fmu.ac.jp/dspace/handle/123456789/527 |
| 本文URL: | http://ir.fmu.ac.jp/dspace/bitstream/123456789/527/1/JAnesth_29_p678.pdf |
| ISSN: | 0913-8668
1438-8359 |
| DOI: | 10.1007/s00540-015-2003-2 |
| PubMed番号: | 25801541 |
| 異版(出版者版等): | http://dx.doi.org/10.1007/s00540-015-2003-2 |
| 権利情報: | © Japanese Society of Anesthesiologists 2015. The final publication is available at link.springer.com. |
| 出現コレクション: | a10 学術雑誌論文等 = Journal Article
|
このリポジトリに保管されているアイテムは、他に指定されている場合を除き、著作権により保護されています。
|
