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. 2022 Jun 10:58:69-76.
doi: 10.29390/cjrt-2022-015. eCollection 2022.

Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review

Mika L Nonoyama  1   2   3 , Vinay Kukreti  4 , Efrosini Papaconstantinou  1   5 , Natascha Kozlowski  6 , Sarah Tsimelkas  1   4
Affiliations

Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review

Mika L Nonoyama et al. Can J Respir Ther. .

Abstract

Objectives: Emergency intubation is a high-risk procedure in children. Studies describing intubation practices in locations other than pediatric centres are scarce and varied. This study described pediatric intubations in adult-based community emergency departments (EDs) and determined what factors were associated with intubated-related adverse events (AEs) and described outcomes of children transferred to a quaternary care pediatric institution.

Methods: This is a retrospective review of data collected between January 2006 and March 2017 at Lakeridge Health and Hospital for Sick Children (SickKids). Patients were <18 years and intubated in Lakeridge Health EDs; those intubated prior to ED arrival were excluded. Primary outcomes were intubation first-pass success (FPS) and AEs secondary to intubation.

Results: Patients (n = 121) were analyzed, and median (interquartile range (IQR)) age was 3.7 (0.4-14.3) years. There were 76 (62.8%) FPS, with no difference between pediatricians (n = 25, 23%) or anaesthetists (n = 12, 11%), versus all other providers (paramedic n = 13 (12%), ED physician n = 37 (34%), respiratory therapist n = 20 (18%), transfer team n = 2 (2%)). The proportion of AEs was 24 (19.8%, n = 21 minor, n = 3 major), with no significant difference between pediatricians or anaesthetists versus all other providers. Data from 68 children transferred to SickKids were available, with the majority extubated within a short median (IQR) time of admission, 1.2 (0.29-3.8) days.

Conclusions: Pediatric intubations were rare in a Canadian adult-based community hospital system. Most intubations demonstrated FPS with relatively few AEs and no significant differences between health provider type. Future investigations should utilize multi-centred data to inform strategies suited for organizations' unique practice cultures, including training programs.

Keywords: community; emergency service; hospital; hospitals; intubation; patient outcome assessment; pediatrics; retrospective studies.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years and no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1
Participant flow diagram.
Figure 2
Figure 2
Time (days) between SickKids admission and extubation.
See this image and copyright information in PMC

References

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