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

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 factor...

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Veröffentlicht in:Biomedical Journal 2024-06, Vol.47 (3), p.100656, Article 100656
Hauptverfasser: Yang, Ting-Hao, Shao, Shih-Chieh, Lee, Yi-Chih, Hsiao, Chien-Han, Yen, Chieh-Ching
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Sprache:eng
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Zusammenfassung: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. 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. 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%). 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. •This study is the first meta-analysis investigating the risk factors of peri-intubation cardiac arrest.•The certainty of evidence that pre-intubation hypotension increases the risk of peri-intubation cardiac arrest is moderate.•Pooled incidence rate of peri-intubation cardiac arrest is 2.1% in this study.•This research could help emergency or critical care physicians identify patients at risk in the acute setting.
ISSN:2319-4170
2320-2890
2320-2890
DOI:10.1016/j.bj.2023.100656