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Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Mortality Prediction of Biochemical Parameters in Patients Intubated in the Emergency Department
Yavuzselim Koca1, Öner Bozan1, Meltem Polat1
1Department of Emergency Medicine, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, TUR.
Abstract:
Introduction Tracheal intubation is a high-risk airway management protocol frequently applied in patients with critical illnesses. Numerous parameters have been suggested to predict mortality in these patients. Blood gas analysis, electrolyte levels, enzyme activities, and other biochemical measurements provide insights into a patient's metabolic status and organ functions. Accordingly, it is considered that these parameters have a significant potential for predicting the clinical outcomes of intubated patients. The study aimed to investigate the role of biochemical parameters in determining the 24-hour mortality risk of patients intubated in the emergency department and understand the potential significance of these parameters in predicting the clinical prognosis of these patients. Methods The present study was conducted on 1,236 patients who were intubated within a 1.5-year period at the Emergency Medicine Clinic of a tertiary Education and Research Hospital. Lactate, hemoglobin (Hgb), platelets (PLT), pH, HCO3, K, urea, creatinine, high-sensitivity troponin I (HS troponin I), and serum sodium levels were recorded for each patient in a data form. The 24-hour mortality rates were then analyzed based on these test results and comorbidities in the patients, and the data were recorded. Results The study included 702 patients after reviewing 1,236 cases. The median/mean values of HCO3, PLT, and pH were significantly higher in survivors compared to those who did not survive within 24 hours. Conversely, the median/mean values of lactate, creatinine, potassium, and HS troponin I were significantly higher in the patients who lost their lives within 24 hours than in the survivors. Epilepsy status, HCO3, lactate, potassium, and PLT values were statistically significant in the multivariate model in predicting 24-hour mortality. Conclusion The results of this study indicate that specific laboratory values, particularly blood gas analysis, play a significant role in predicting mortality among patients who present to the emergency department and undergo rapid sequence intubation. Patient prognosis can be predicted using these parameters, and treatment can be planned accordingly. Future multicenter prospective studies using standardized patient-specific intubation could provide further evidence for using the parameters in question in predicting mortality.
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