Paediatric anaesthesia & critical care
Comparative Analysis of Tracheal Intubation–Associated Cardiac Arrest in 2015–2023: A Report From the National Emergency Airway Registry for Children Multicenter Registry
Authors' conclusion
TI-CA occurred in 1.2% of TIs performed in the PICUs. Odds of TI-CA increased incrementally with successive TI attempts. Video laryngoscopy was protective against TI-CA. Mediation analysis revealed that reduced TI attempts accounted for 13% of the protective benefit associated with video laryngoscopy.
Study context
- Population
- Critically ill children requiring tracheal intubation in PICUs and PCICUsTIs evaluated, seventy international PICUs and PCICUs
- Participants
- 27,773 children
- Exposure
- Patient and procedural factors associated with TI-CA
- Outcome
- Incidence of TI-CA (CA occurrence or receipt of chest compressions for at least 1 minute within 20 minutes of endotracheal tube placement)
Methodological detailsmulticenter registry, tracheal intubation data prospectively collected
- Multicenter registry
- Tracheal intubation data prospectively collected
Main finding
As reported in the abstract
TI-CA reported (of TIs evaluated)
1.2%
n = 331
Observational data: associations, not effects.
Further findings
TI-CA by pre-TI oxygenation failure and shock
| aOR for TI-CA (95% CI) | ||
|---|---|---|
| Pre-TI oxygenation failureHigher odds | 2.29 (1.81–2.89) | |
| ShockHigher odds | 4.67 (3.68–5.92) | |
| 0.20.5125AOR for TI-CA (log scale) |
| Outcome | aOR for TI-CA (for each attempt) (95% CI) | |
|---|---|---|
| TI-CA by number of TI attemptsIncreased odds | 1.70 (1.56–1.85) | |
| 0.512AOR for TI-CA (log scale) |
TI-CA by induction agents and devices
| aOR for TI-CA (95% CI) | ||
|---|---|---|
| KetamineLower odds | 0.64 (0.49–0.82) | |
| PropofolLower odds | 0.44 (0.27–0.72) | |
| Neuromuscular blockadeLower odds | 0.67 (0.49–0.91) | |
| Video laryngoscopyLower odds | 0.76 (0.6–0.97) | |
| 0.20.5125AOR for TI-CA (log scale) |
Mediation by reduced TI attempt counts
- Video laryngoscopy's protective effect due to a reduction in TI attempt counts
- 13%
- Ketamine, mediated by reduced TI attempt counts
- 5%
- Propofol, mediated by reduced TI attempt counts
- 4%
- Neuromuscular blockade, mediated by reduced TI attempt counts
- 7%
- Mediation analysis
Original publication
Comparative Analysis of Tracheal Intubation–Associated Cardiac Arrest in 2015–2023: A Report From the National Emergency Airway Registry for Children Multicenter Registry. Crit Care Med. Published 23 October 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →