The Effects Of Different Timing Of Endotracheal Intubation On The Patients Of Cardiac Arrest In ICU

ObjectiveTo compare the effects of different timing of intubation on the prognosis of patients with cardiopulmonary resuscitation in ICU.MethodsWe performed a retrospective analysis in 736 patients with cardiac arrest in ICU in Henan Provincial Hospital from 2014 to 2016.The times of intubation during CPR were categorized into two groups: early intubation group within six minutes and delayed intubation group With more than six minutes from cardiac arrest to cardiopulmonary resuscitation.The main outcome was the survival rate in hospital.The secondary outcomes included spontaneous circulation recovery rate,the 24 h survival rate and good neurological outcome.ResultsA total of 736 patients was included in this analysis.Among them,357 patients had early intubation and 379 had delayed intubation.There were no statistically differences in the baseline characteristics among the two groups in terms of gender,age,and etiology of cardiac arrest.A totoal of 233 patients(31.70%)recovered spontaneously among all the patients,135 patients(18.30%)survived within 24 h and 68 patients(9.20%)survived in hospital.The neurological outcome was excellent in 11 patients(1.5%).There was no significant difference in the rate of survival in hospital between the two groups(χ~2 = 4.135 p = 0.055).The 24 h survival rate was statistically significantly higher in delayed intubation than in early intubation(χ~2 = 6.602 p = 0.013).There was no significant difference in the rate of good neurological outcome between the two groups(χ~2 = 0.042 p = 0.838).Univariate Logistic regression analysis showed that delayed tracheal intubation was a protective factor for survival in the hospital(OR=0.866(95% CI 0.778-0.965 p = 0.009).In the multivariate Logistic regression model,age,gender,initial rhythm and etiology were not related to outcomes.ConclusionsThere was no correlation between the times of tracheal intubation and in-hospital survival,but it seems that the delayed tracheal intubation could improve the recovery rate of spontaneous circulation in patients with cardiac arrest.