| Objective: To assess the risk of emergent endotracheal intubationsand to determine the risk factors of complications.Methods: We conducted a prospective study of all emergentintubations occurring in PICU of our hospital between November2011andMay2012．Data including age, gender，Admission disease, intubation time,indication for intubation, intubation approach, complications was collectedwith unified tables(see Appendix table-1). Emergent intubations weredefined by Chief resident and attending physician according to Clinicalsymptoms, artery blood gas analysis and Spo2.Intubations occurring onweekends or between5:30PM and8AM on weekdays were categorized as"off-hours." All the children were divided into groups as follow: group ofany complication and group of no complication, group of off-hoursintubations and group of on-hours intubations, group of immediatelyintubations and unimmediately intubations.Results:1、Emergent endotracheal intubations are1.7times more likely to occur off-hours. off-hours intubations are associated with2.7times the riskof complications as on-hours intubations.2、immediately intubations are2.8times more likely to occuroff-hours. immediately intubations are associated with3times or4times ofthe risk of complications as un-immediately intubations.3、the group of immediately intubations have lower PCIS than these ofun-immediately intubations(P<0.05)4、In a multivariate logistic regression analysis, nasal trachealintubation, two or more attempts at intubation, and off-hours intubationincreased the likelihood of experiencing a complication.5、69.1%emergent intubations have complications includinghypoxemia (67.9%), bradycardia(29.8%), Vomiting (16.7%).Conclusions：1、Emergent endotracheal intubation are1.7times more likely to occuroff-hours. off-hours intubations are associated with complications.2、It may be that more critically ill children are on admission whichlead to more immediately intubations occurring during off-hours timeperiod. |
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