...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Paediatric anaesthesia >Risk factors and outcomes associated with unplanned intraoperative extubation of the pediatric surgical patient: An analysis of the NSQIP-P database
【24h】

Risk factors and outcomes associated with unplanned intraoperative extubation of the pediatric surgical patient: An analysis of the NSQIP-P database

机译：Risk factors and outcomes associated with unplanned intraoperative extubation of the pediatric surgical patient: An analysis of the NSQIP-P database

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相关主题

摘要

BackgroundUnplanned intraoperative extubation is a rare but potentially catastrophic safety event. Inadvertent extubation in the neonatal and pediatric critical care setting is a recognized quality improvement metric whereas literature for intraoperative extubation is scarce. The aim of this study was to identify risk factors and outcomes associated with unplanned intraoperative extubation.MethodsWe queried the National Surgical Quality Improvement Program-Pediatric database from 2019 to 2020 for patients <18 years of age. A total of 253 673 patients were included in the analysis. Associations between demographics, clinical variables, and unplanned intraoperative extubation were evaluated with univariable and multivariable logistic regression models. The primary outcome was unplanned intraoperative extubation. Secondary outcomes were postoperative pulmonary complication, unplanned reintubation within 24 h, cardiac arrest on day of surgery, and surgical site infection.ResultsUnplanned intraoperative extubation occurred in 163 (0.06) patients. Specific procedures experienced unplanned intraoperative extubation at a higher rate such as bilateral cleft lip repair (1.31 of procedure type) and thoracic repair of tracheoesophageal fistula (1.11 of procedure type). Age, operative time (z-score), American Society of Anesthesiologists Classification 3 and 4, neurosurgery, plastic surgery, thoracic surgery, otolaryngology, and structural pulmonary/airway abnormalities were independent risk factors. Unplanned intraoperative extubation was associated with an increased unadjusted risk for postoperative pulmonary complication (p < .005; OR, 6.05; 95 confidence interval CI: 1.93-14.44), unplanned reintubation within 24 h (p < .005; OR, 8.41; 95 CI: 2.08-34.03), cardiac arrest on day of surgery (p < .05; OR, 22.67; 95 CI: 0.56-132.35), and surgical site infection (p < .0005; OR, 3.27; 95 CI 1.74-5.67).ConclusionsUnplanned intraoperative extubation occurs at a higher frequency in a subset of procedures and patient types. Identifying and targeting at-risk patients with preventative measures may decrease the incidence of unplanned intraoperative extubation and its associated outcomes.

著录项

获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号