Are «off hours» intubations a risk factor for complications during intubation? A prospective, observational study

Abstract

Objective: To compare the complications and the difficulty of orotracheal intubation procedures performed in the Intensive Care Unit during the off-hours period and the on-hours period.

Design: A prospective, observational and non-interventional cohort study covering a period of 27 months was carried out. Working days between 8:00 a. m. and 7:59 p. m. were considered «on-hours», while the remaining shifts were regarded as «off-hours».

Scope: An 18-bed surgical in a Intensive Care Unit of a third-level hospital.

Patients: All orotracheal intubation patients admitted to the ICU from January 2015 to March 2017 were included. Patients were stratified into 2groups according to whether intubation was performed on-hours or off-hours.

Interventions: Non-interventional study.

Variables of interest: The reason for intubation, time and day on which intubation was performed, degree of intubation difficulty (number of attempts, Cormack-Lehane laryngoscopic vision, need for accessory material) and complications during intubation.

Results: A total of 252 patients were intubated; of these, 132 were included in the on-hours group and 120 patients in the off-hours group. In the off-hours group we observed a greater percentage of urgent and emergent intubations compared to the on-hours group. However, no differences were found between the 2groups in relation to the other variables studied.

Conclusions: During the off-hours period, orotracheal intubation was not associated to a greater number of complications or to greater difficulty of the technique in our Unit.

Keywords: Complicaciones; Complications; Critical care; Cuidados críticos; Hipotensión; Hipoxia; Hypotension; Hypoxia; Intensive Care Unit; Intubación orotraqueal; Orotracheal intubation; Unidad de Cuidados Intensivos.