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Tracheal Intubation-related adverse events in pediatrics anesthesia in Ethiopia
Tadese Tamire1, Bayisa Garbessa2, Geresu Gebeyehu3
1Department of Anaesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Insights
Pediatric tracheal intubation in Ethiopia has a high rate of adverse events (36.5%). Factors like emergency surgery and difficult intubation increase risks, necessitating improved strategies for patient safety.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Tracheal intubation is a critical procedure for pediatric surgical patients, yet it carries inherent risks of morbidity and mortality.
- There is a significant lack of data on adverse events associated with pediatric tracheal intubation in Ethiopia.
- This study addresses this gap by investigating the incidence and associated factors of tracheal intubation-related adverse events in pediatric surgical patients.
Purpose of the Study:
- To determine the incidence of tracheal intubation-related adverse events in pediatric surgical patients.
- To identify factors associated with these adverse events in the Ethiopian context.
- To provide evidence-based recommendations for improving patient safety during pediatric intubation.
Main Methods:
- An institutional-based cross-sectional study was conducted involving 310 pediatric surgical patients.
- Data were collected from December 2019 to February 2020 and analyzed using descriptive statistics and logistic regression.
- Statistical significance was set at a P-value of less than .05.
Main Results:
- The overall incidence of tracheal intubation-related adverse events was 36.5%.
- Independent predictors included being a neonate, emergency surgery, difficult intubation, lack of premedication, lack of muscle relaxant, and more than three intubation attempts.
- Specific odds ratios (AOR) and confidence intervals (CI) were reported for each predictor.
Conclusions:
- The incidence of adverse events related to tracheal intubation in pediatric surgical patients is notably high.
- Anesthesia professionals must employ vigilance and strategic planning, especially for high-risk patients.
- Implementing difficult airway algorithms, continuous oxygen saturation monitoring, and simulation-based training are crucial for reducing patient harm.
Background:
Tracheal intubation is a common intervention for many pediatric surgical patients. Even though it can be lifesaving, it carries a risk of morbidity and even mortality. Evidence is lacking regarding the adverse events related to pediatric intubation in Ethiopia. This study is aimed to assess the scale of tracheal intubation-related adverse events with its associated factors in pediatrics surgical patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods:
An Institutional-based cross-sectional study was conducted on 310 pediatric surgical patients who underwent major surgery from December 30, 2019, to February 30, 2020. All pediatrics patients scheduled for surgery under general anesthesia in the study period were included in this study. Data with complete information were entered into Epi Info version 7 and exported to SPSS version 22 for analysis. Descriptive statistics, bivariate, and multivariable logistic regression were computed to identify factors associated with tracheal intubation-related adverse events. The level of statistical significance was declared at a P-value of less than .05.
Result:
In this study, the overall incidence of tracheal intubation-related adverse events in pediatrics patients was 36.5%. Being a neonate (AOR = 4.13, 95% CI: 1.26-13.49), emergency surgery (AOR = 3.39, 95% CI: 1.41-8.13), difficult intubation (AOR, 4.08, 95% CI: 1.01-7.50), intubation without using premedication (AOR = 1.75, 95% CI: 1.45-10.83), intubation without using muscle relaxant (AOR = 1.81; 95% CI: 1.10-8.14), and tracheal intubation attempted more than three times (AOR = 3.92, 95% CI: 0.16-7.39) were identified as independent predictors of tracheal intubation-related adverse events.
Conclusion And Recommendations:
The incidence of tracheal intubation-related adverse events in pediatric surgical patients is high. Anesthesia professionals should be vigilant and have a preplanned strategy to avoid intubation-related adverse events, especially in high-risk patients. The use of difficult airway algorithms, oxygen saturation monitoring, and training in simulation room are very important strategies to help reduce patient harm.
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