Cardiac arrest & resuscitation
Airway and respiratory complications during anaesthesia and associated with peri‐operative cardiac arrest as reported to the 7th National Audit Project of the Royal College of Anaesthetists
Authors' conclusion
Overall, these data, while distinct from the 4th National Audit Project, suggest that airway management is likely to have become safer in the last decade, despite the surgical population having become more challenging for anaesthetists.
Study context
- Population
- Patients receiving anaesthesia care, including peri-operative cardiac arrest (National Audit Project (NAP7), Royal College of Anaesthetists)
- Participants
- 24,721 surveyed cases
- Outcome
- Airway and respiratory complications during anaesthesia and associated with peri-operative cardiac arrest
Methodological detailsactivity survey and case registry, 7th National Audit Project
- Activity survey and case registry
- 7th National Audit Project
Main finding
As reported in the abstract
Airway and respiratory complications (activity survey)
- Airway complications
- 421
- Respiratory complications
- 264
- Laryngospasm (of airway complications)
- 157, 37%
- Airway failure (of airway complications)
- 125, 30%
- Aspiration (of airway complications)
- 27, 6%
- Emergency front of neck airway
- 1 in 8370 (95% CI 1 in 2296-30,519)
- Severe ventilation difficulty (of respiratory complications)
- 97, 37%
- Hyper/hypocapnia (of respiratory complications)
- 63, 24%
- Hypoxaemia (of respiratory complications)
- 62, 23%
Observational data: associations, not effects.
Further findings
Peri-operative cardiac arrests and deaths due to airway and respiratory complications (881 reports, 358 deaths)
- Cardiac arrests from airway/respiratory complications
- 113 (13%)
- Deaths from airway/respiratory complications
- 32 (9%)
- Hypoxaemia the most common primary cause
- Survival higher in airway and lower in respiratory cases than other causes of cardiac arrest
- Obesity, young children (particularly infants) and out-of-hours care overrepresented
Cardiac arrest from emergency front of neck airway and pulmonary aspiration
- Emergency front of neck airway (≈1 in 450,000)
- 6
- Pulmonary aspiration (≈1 in 25,000)
- 11
Safety
Unrecognised oesophageal intubation
- Cases
- 6
- Resulting in cardiac arrest
- 3
- Failure to correctly interpret capnography a recurrent theme
Original publication
Airway and respiratory complications during anaesthesia and associated with peri‐operative cardiac arrest as reported to the 7th National Audit Project of the Royal College of Anaesthetists. Anaesthesia. Published 30 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →