Publication: Unplanned intubation during anesthesia: Review of 31 cases from the Thai Anesthesia Incidents Study (THAI Study)
Issued Date
2006-02-01
Resource Type
ISSN
01252208
01252208
01252208
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2-s2.0-33646001099
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.89, No.2 (2006), 224-230
Suggested Citation
Waraporn Chau-In, Thitima Chinachoti, Yodying Punjasawadi, Sireeluck Klanarong, Kanok Taratarnkoolwatana Unplanned intubation during anesthesia: Review of 31 cases from the Thai Anesthesia Incidents Study (THAI Study). Journal of the Medical Association of Thailand. Vol.89, No.2 (2006), 224-230. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/23834
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Title
Unplanned intubation during anesthesia: Review of 31 cases from the Thai Anesthesia Incidents Study (THAI Study)
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Abstract
Objectives: To examine the causes, outcomes, and contributing factors associated with patients requiring unplanned emergency intubation for adverse respiratory events. Meterial and Method: Appropriate unplanned intubation incidents were extracted from the Thai Anesthesia Incidents Study (THAI Study) database conducted between February 1, 2003, and January 31, 2004, and analyzed using descriptive statistics. Results: Thirty-one incidents of unplanned intubation were recorded, 21 of which were due to respiratory problems particularly after bronchoscopy with and without surgery of the upper airway. Six of the 21 cases (28.6%) were children under 10 years of age who suffered from papilloma of the larynx. Sixteen cases of the 31 cases (52%) of the unplanned intubations were due to inadequate ventilation; 13 cases (41%) due to laryngeal edema; 11 cases (36%) due to sedative agents. The other events were the result of unstable hemodynamics, severe metabolic acidosis, muscle relaxants, and intrapulmonary lesions. Eighteen cases of unplanned intubations (18/31) (58%) occurred in the Post-Anesthesia Care Unit, 5 cases (16%) in a ward, and 4 (13%) in the operating room. The reported contributing factors included inadequate experience, lack of supervision and the patient's condition. Conclusion: Major incidents of unplanned intubation occurred after bronchoscopy. Common contributing factors related to inadequate ventilation, airway obstruction, sedative agents and unstable hemodynamics. Quality assurance, additional training, and improved supervision tended to minimize the incidents.