A prospective, cohort evaluation of major and minor airway management complications during routine anaesthetic care at an academic medical centre.
The aim of this study was to develop an audit tool to identify prospectively all peri-operative adverse events during airway management in a cost-effective and reproducible way. All patients at VU University Medical Center who required general anaesthesia for elective and emergency surgical procedures were included during a period of 8 weeks. Daily questionnaires and interviews were taken from anaesthesia trainees and anaesthetic department staff members. A total of 2803 patients underwent general anaesthesia, 1384 men and 1419 women, including 2232 elective patients and 571 emergency procedures, 697 paediatric and 2106 adult surgical procedures. A total of 168 airway-related events were reported. The incidence of severe airway management-related events was 24/2803 (0.86%). There were 12 (0.42%) unanticipated ICU admissions, two patients (0.07%) required a surgical airway. There was one (0.04%) death, one cannot intubate cannot oxygenate (0.04%), one aspiration (0.04%) and eight (0.29%) severe desaturations < SpO250%. We suggest that our method to determine and investigate airway management-related adverse events could be adopted by other hospitals.
VU University Medical Center, Amsterdam, the Netherlands.
J M
JM
Huitink
VU University Medical Center, Amsterdam, the Netherlands.
P P
PP
Lie
VU University Medical Center, Amsterdam, the Netherlands.
I
I
Heideman
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands.
E P
EP
Jansma
Department of Anesthesiology and Pain Therapy, Bern University Hospital, University of Bern, Bern, Switzerland.
R
R
Greif
VU University Medical Center, Amsterdam, the Netherlands.
N
N
van Schagen
VU University Medical Center, Amsterdam, the Netherlands.
A
A
Schauer
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058109:Airway Management / Q000009:adverse effects* / Q000379:methods; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D002648:Child; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008485:Medical Audit / Q000379:methods; D008875:Middle Aged; D009426:Netherlands; D010343:Patient Admission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
airway management; brain damage; complications; emergency surgical airway; general anaesthesia; serious adverse events