Articles  |   February 2018
SEE Question
Article Information
Airway Management / Cardiovascular Anesthesia / Critical Care / Education / CPD / Respiratory System / Articles
Articles   |   February 2018
SEE Question
ASA Monitor 02 2018, Vol.82, 52-53.
ASA Monitor 02 2018, Vol.82, 52-53.
A “code blue” is called at your hospital, and you rush into the crowd, ready to intubate the patient. According to an analysis on tracheal intubation during in-hospital cardiac arrest, which of the following is most likely true about patients who were intubated versus those who were not?
The multicenter Get With The Guidelines–Resuscitation registry sponsored by the American Heart Association (AHA) is the largest, most comprehensive database of cardiac arrests in US hospitals. For a recent study, researchers retrospectively looked at data from January 1, 2000 to December 31, 2014 for patients aged 18 years and older who suffered a cardiac arrest, defined as pulselessness requiring chest compressions or defibrillation with an emergency response activation. The primary purpose of the study was to determine whether early tracheal intubation (i.e., within 15 minutes of resuscitation) was associated with survival to discharge. Secondary measures of interest included a return of spontaneous circulation (ROSC) and good functional outcome. Patients with a do-not-resuscitate order, an invasive airway at the time of arrest, or missing data on tracheal intubation, survival, or other covariates were excluded from the analysis. Because there is no prospective (and ethical) way to measure intubation’s effectiveness, the authors used time-dependent propensity score matching that has been used in other cardiac arrest interventions. This meant that patients intubated at a certain time during the arrest were propensity matched (e.g., same comorbidities, type of arrest, location) to another patient who was considered at risk of being intubated at that same time.
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