Risk factors for peri-intubation cardiac arrest: A systematic review and meta-analysis

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Biomedical Journal Pub Date : 2024-06-01 DOI:10.1016/j.bj.2023.100656

Ting-Hao Yang , Shih-Chieh Shao , Yi-Chih Lee , Chien-Han Hsiao , Chieh-Ching Yen

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引用次数: 0

Abstract

Background

Peri-intubation cardiac arrest (PICA) is an uncommon yet serious complication of intubation. Although some associated risk factors have been identified, the results have been inconsistent. The aim of this study was to systematically review the relevant research and examine the associated risk factors of PICA through meta-analysis.

Methods

Studies examining the risk factors for PICA before 1 Nov. 2022 were identified through searches in MEDLINE (OvidSP) and EMBASE. The reported adjusted or unadjusted odds ratios (ORs) and risk ratios (RRs) were recorded. We calculated pooled ORs and created forest plots using a random-effects model to identify the statistically significant risk factors. We assessed the certainty of evidence for each risk factor.

Results

Eight studies were included in the meta-analysis. Pre-intubation hypotension, with a pooled OR of 4.96 (95% confidence interval [C.I.]: 3.75–6.57), pre-intubation hypoxemia, with a pooled OR of 4.43 (95% C.I.: 1.24–15.81), and two or more intubation attempts, with a pooled OR of 1.88 (95% C.I.: 1.09–3.23) were associated with a significantly higher risk of PICA. The pooled incidence of PICA was 2.1% (95% C.I.: 1.5%–3.0%).

Conclusions

Pre-intubation hypotension, hypoxemia, and more intubation attempts are significant risk factors for PICA. The findings could help physicians identify patients at risk under the acute setting.

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插管周围心脏骤停的风险因素：系统回顾和荟萃分析

背景插管前心脏骤停（PICA）是插管过程中一种不常见但却很严重的并发症。虽然已经发现了一些相关的风险因素，但结果并不一致。方法通过在 MEDLINE (OvidSP) 和 EMBASE 中检索，确定了 2022 年 11 月 1 日之前研究 PICA 危险因素的研究。记录报告的调整或未调整的几率比（ORs）和风险比（RRs）。我们计算了汇总的 ORs，并使用随机效应模型绘制了森林图，以确定具有统计学意义的风险因素。我们对每个风险因素的证据确定性进行了评估。插管前低血压的汇总 OR 值为 4.96（95% 置信区间 [C.I.]：3.75-6.57），插管前低氧血症的汇总 OR 值为 4.43（95% 置信区间：1.24-15.81），两次或两次以上插管尝试的汇总 OR 值为 1.88（95% 置信区间：1.09-3.23），这些因素与 PICA 风险显著增高有关。结论插管前低血压、低氧血症和多次插管尝试是 PICA 的重要风险因素。这些发现有助于医生识别急性期的高危患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biomedical Journal Medicine-General Medicine

CiteScore

11.60

自引率

1.80%

发文量

128

审稿时长

42 days

期刊介绍： Biomedical Journal publishes 6 peer-reviewed issues per year in all fields of clinical and biomedical sciences for an internationally diverse authorship. Unlike most open access journals, which are free to readers but not authors, Biomedical Journal does not charge for subscription, submission, processing or publication of manuscripts, nor for color reproduction of photographs. Clinical studies, accounts of clinical trials, biomarker studies, and characterization of human pathogens are within the scope of the journal, as well as basic studies in model species such as Escherichia coli, Caenorhabditis elegans, Drosophila melanogaster, and Mus musculus revealing the function of molecules, cells, and tissues relevant for human health. However, articles on other species can be published if they contribute to our understanding of basic mechanisms of biology. A highly-cited international editorial board assures timely publication of manuscripts. Reviews on recent progress in biomedical sciences are commissioned by the editors.