Comparative study of indications, complications and outcome of elective and emergency intubation
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2017, Vol 23, Issue 1
Abstract
Objectives: Acute respiratory failure frequently necessitates the introduction of endotracheal tube to maintain airway patency and for mechanical ventilation. Intubation is a procedure in day today practice in EMS, medical wards, operation theatres. This is study done retrospectively of 200 patients to correlate the factors which affect outcome of intubation age, sex, nature of underlying disease. The purpose of this study is also to determine whether intubation alone or subsequent tracheostomy in previously intubated patients can prognosticate outcome and the complications of endotracheal intubation and tracheostomy as acquired either during the procedure, with tube in situ or on extubation. Methods: A retrospective study of 200 adult patients was conducted, who satisfied inclusion and exclusion criteria for intubation on elective or emergency grounds over a period of 18 months. Patient’s demographic data along with lab tests of Sr. Creatinine, Sr. K+, ABG analysis, chest X-ray Mallampatti grade was noted. The indication for intubation as elective or emergency was based on ABG or severity of respiratory failure or for tracheal toileting. SOFA score, GCS score at Admission and 48 hrs was noted. Results: In this study, 200 patients were intubated. Out of which 137 were elective 63 emergency and 146 were Males and 54 were Females. Major age group was 21-40 years. Organ involvement in form of respiratory (168 patients), hepatic(19 patients), renal failure(44 patients) or MODS (18 patients) didn’t affect outcome in these patients. The overall mortality rate of the study was 37%. The disease specific mortality for sepsis patients was 100%, Coma was 56.2% and pneumonia was 52.4%. The elective intubated patients had lower mortality (32.1%) compared to that of emergency intubated patients (47.6%). Conclusion: Patients have to be intubated electively and early tracheostomy at 72- 96 hrs has improved survival.
Authors and Affiliations
Swati Chavan, Rupal Padhiyar, Aniket Mohite, Swapnil Dhampalwar
Keywords
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