J Clin Monit Comput - Respiratory parameters as a surrogate marker for duration of intubation: potential application of automated vital sign collection.

Tópicos

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Resumo

Prolonged time during endotracheal tube placement has been associated with poor outcomes, including cardiac arrest and death. For this reason, the accurate measurement of the duration of intubation time is an important metric in studies that evaluate interventions to improve airway outcomes. In the current study we correlated the gaps in routinely measured ventilatory parameters with duration of the intubation procedure to determine if these intervals could be used to accurately calculate the intubation time. Fifty-six random airway management encounters were video recorded along with a continuous video feed of the patient monitor. Intubation event times were measured and correlated with "gap" times of end-tidal carbon dioxide, airway pressure, airway flow, tidal volume, and respiratory rate defined as the disappearance of the parameter at the end of mask ventilation to the reappearance after intubation. Scatter plots were generated for intubation times versus each parameter time gap and correlation coefficients were calculated. Of the 56 recordings 50 of were suitable for analysis. The correlation of the gaps in airway pressure and airway flow correlated best with the duration of intubation (R(2)?=?0.88) and were available on all cases. The gap in measured tidal volume of 39???53?s most closely approximated the actual duration of intubation of 38???28?s, (R(2)?=?0.85, y?=?x?-?0.87). During intubation, the disappearance gaps in tidal volume, and the airway pressure and flow waveforms highly correlate with the duration of the intubation procedure and may be useful in the evaluation of airway management interventions. However, just as there are limitations to a labor-intensive method of recording airway management timing, there are limitations to using an automated method.

Resumo Limpo

prolong time endotrach tube placement associ poor outcom includ cardiac arrest death reason accur measur durat intub time import metric studi evalu intervent improv airway outcom current studi correl gap routin measur ventilatori paramet durat intub procedur determin interv use accur calcul intub time fiftysix random airway manag encount video record along continu video feed patient monitor intub event time measur correl gap time endtid carbon dioxid airway pressur airway flow tidal volum respiratori rate defin disappear paramet end mask ventil reappear intub scatter plot generat intub time versus paramet time gap correl coeffici calcul record suitabl analysi correl gap airway pressur airway flow correl best durat intub r avail case gap measur tidal volum s close approxim actual durat intub s r yx intub disappear gap tidal volum airway pressur flow waveform high correl durat intub procedur may use evalu airway manag intervent howev just limit laborintens method record airway manag time limit use autom method

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