TY - JOUR
AU - Yao, Wenlong
AU - Wang, Tingting
AU - Jiang, Bailin
AU - Gao, Feng
AU - Wang, Li
AU - Zheng, Hongbo
AU - Xiao, Weimin
AU - Yao, Shanglong
AU - Mei, Wei
AU - Chen, Xiangdong
AU - Luo, Ailin
AU - Sun, Liang
AU - Cook, Tim
AU - Behringer, Elizabeth C.
AU - Huitink, Johannes M.
AU - Wong, David T.
AU - Lane-Fall, Meghan
AU - McNarry, Alistair F.
AU - McGuire, Barry
AU - Higgs, Andrew
AU - Shah, Amit
AU - Patel, Anil
AU - Zuo, Mingzhang
AU - Ma, Wuhua
AU - Xue, Zhanggang
AU - Zhang, Li Ming
AU - Li, Wenxian
AU - Wang, Yong
AU - Hagberg, Carin A.
AU - O'Sullivan, Ellen P.
AU - Fleisher, Lee A.
AU - Wei, Huafeng
AU - Peng, Zhiyong
AU - Liang, Hansheng
AU - Nishikawa, Koji
PY - 2020
DA - July
TI - Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations
JO - British Journal of Anaesthesia
EP - 37
VL - 125
IS - 1
DO - https://doi.org/10.1016/j.bja.2020.03.026
AB - Tracheal intubation in coronavirus disease 2019 (COVID-19) patients creates a risk to physiologically compromised patients and to attending healthcare providers. Clinical information on airway management and expert recommendations in these patients are urgently needed. By analysing a two-centre retrospective observational case series from Wuhan, China, a panel of international airway management experts discussed the results and formulated consensus recommendations for the management of tracheal intubation in COVID-19 patients. Of 202 COVID-19 patients undergoing emergency tracheal intubation, most were males (n=136; 67.3%) and aged 65 yr or more (n=128; 63.4%). Most patients (n=152; 75.2%) were hypoxaemic (SaO2&lt;90%) before intubation. Personal protective equipment was worn by all intubating healthcare workers. Rapid sequence induction (RSI) or modified RSI was used with an intubation success rate of 89.1% on the first attempt and 100% overall. Hypoxaemia (SaO2&lt;90%) was common during intubation (n=148; 73.3%). Hypotension (arterial pressure &lt;90/60 mm Hg) occurred in 36 (17.8%) patients during and 45 (22.3%) after intubation with cardiac arrest in four (2.0%). Pneumothorax occurred in 12 (5.9%) patients and death within 24 h in 21 (10.4%). Up to 14 days post-procedure, there was no evidence of cross infection in the anaesthesiologists who intubated the COVID-19 patients. Based on clinical information and expert recommendation, we propose detailed planning, strategy, and methods for tracheal intubation in COVID-19 patients.
PB - Elsevier
UR - https://discovery.dundee.ac.uk/en/publications/94afa007-32a7-48d3-b7d0-473e193ab688
KW - Coronavirus (COVID-19)
KW - Hospital care
ER