Pediatric anesthesia & critical care
Effect of apneic oxygenation with intubation to reduce severe desaturation and adverse tracheal intubation-associated events in critically ill children
Main findingResult — go to the resultAdjusted odds ratio 0.75 95% CI 0.58–0.98Authors' conclusion
While AO use was associated with a lower occurrence of adverse TIAEs in children who required TI in the pediatric ICU after accounting for site-level clustering, this result may be explained by differences in patient, provider, and practice factors.
Study context
- Population
- Critically ill children undergoing tracheal intubation (TI) in 14 PICUs, 2016–2020
- Participants
- 6,549 TIs
- Comparison
- Apneic oxygenation (AO) via nasal cannula during apneic phase of TI vs without AO
- Outcome
- Adverse TI-associated events (TIAEs)
Methodological detailspre- vs post-implementation, quality improvement intervention, before-after implementation
- Pre- vs post-implementation
- Quality improvement intervention
- Before-after implementation
Main finding
As reported in the abstract
Adjusted odds ratio
0.75
95% CI 0.58–0.98
P = 0.03
By group
AO vs without AO
aOR 0.75 (95% CI 0.58–0.98); P = 0.03
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Adverse TIAEs, adjusted for patient and provider characteristics (secondary analysis) | 0.90 (0.72–1.12) | P = 0.33 | |
| 0.512Adjusted odds ratio (log scale) |
Hypoxemia (SpO2 < 80%)
P = 0.43
AO utilization, pre- vs post-implementation
- AO utilization increased from 23 to 68%
- P < 0.001
- 2554 (39.0%) TIs pre-implementation, 3995 (61.0%) post-implementation
Original publication
Effect of apneic oxygenation with intubation to reduce severe desaturation and adverse tracheal intubation-associated events in critically ill children. Crit Care. Published 17 January 2023. doi:10.
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