Comparison of drugs used for intubation of pediatric trauma patients
| Autor: | Neil Merritt, Jacob D. Davidson, Martina Mudri, Fran Priestap, Andrew K. Williams |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Adolescent Traumatic brain injury Midazolam medicine.medical_treatment 03 medical and health sciences Injury Severity Score 0302 clinical medicine Etomidate 030225 pediatrics Brain Injuries Traumatic London medicine Humans Hypnotics and Sedatives Intubation Rapid Sequence Induction and Intubation Child Propofol Retrospective Studies business.industry Infant Newborn Infant Shock General Medicine Length of Stay Hospitals Pediatric medicine.disease Child Preschool 030220 oncology & carcinogenesis Anesthesia Pediatrics Perinatology and Child Health Female Ketamine Surgery Hypotension business medicine.drug Pediatric trauma Biomedical sciences |
| Zdroj: | Journal of Pediatric Surgery. 55:926-929 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2020.01.041 |
| Popis: | Purpose Rapid sequence intubation (RSI) drugs, such as propofol, affect clinical outcomes, but this has not been examined in the pediatric population. This descriptive study compares the outcomes associated with intubation drugs used in pediatric traumatic brain injury (TBI) patients. Methods A retrospective chart review and descriptive analysis of intubated TBI patients, ages 0–17, admitted to Children's Hospital London Health Sciences Centre (LHSC) from January 2006–December 2016 was performed. Results Out of 259 patients intubated, complete data was available for 107 cases. Average injury severity score was 28; 46 were intubated at LHSC, 55 at primary care site, and 6 on scene. Intubation attempts were recorded in 87 of 107 paper charts. First-pass intubation success rate was 88.5%. Propofol (n = 21), midazolam (n = 31), etomidate (n = 13), and ketamine (n = 7) were the most commonly used intubation drugs. Paralytics were used in 50% of patients. Following use of propofol, Pediatric Adjusted Shock Index was increased as a result of worsening hypotension. Mean total hospital length of stay was 21 days with 7.5 days in ICU. Survival was 87%. Conclusion Great variability exists in the use of induction agents and paralytics for RSI. Propofol was commonly used and is potentially associated with poorer clinical outcomes. Type of Study Retrospective. Level of Evidence IV |
| Databáze: | OpenAIRE |
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