Incidence and Outcome of Reintubation in the PACU

NCT ID: NCT05341596

Last Updated: 2022-04-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

121965 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-01-01

Study Completion Date

2020-10-01

Brief Summary

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This study evaluated the occurrence of reintubation after planned extubation (RAP), the impact of RAP on duration of PACU stay,length of stay,length of postoperative stay,inpatient healthcare costs, unanticipated ICU admission and readmission.

Detailed Description

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The study was carried out in Wuhan City, China at a general public university hospital with 62 clinical departments, 99 surgical rooms, and 38 beds in the PACU. The total number of operations performed in this hospital is more than 90,000/year. The study was approved by the hospital ethics committee and was deemed that written patient consent was not required. The adverse events, including RAP, in all patients in the PACU were recorded on a standardized form in a database by pre-trained qualified nurses and/or anesthesiologists at the time of care from January 1, 2017 to December 31, 2019.

Data, including patient demographic and surgical and anesthesia parameters, were obtained from the anesthesia information system. Adverse events management and duration of PACU stay were also documented. For three years, all collected data were filed in a computer every day and were summarized and analyzed every month. Data, such as demographics, airway, oxygen saturation, consciousness, treatment, vital signs, and fast-track criteria scores, were recorded for all patients in the PACU. The first part contained preoperative and intraoperative data, which were entered into the database by the anesthesiologists involved in the patients' intraoperative care from the time of PACU admission. The second part were recorded by nurse and comprised postoperative data from the PACU to the ward or ICU. The third part were recorded by the surgeons and/ or surgical nurses and comprised postoperative data. The criteria for tracheal extubation in the operating room(OR) and the timing of transfer to the PACU were the responsibility of the anesthesiologist.

Conditions

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Postoperative Complications Complication of Medical Care

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Reintubation after planned extubation

Reintubation after planned extubation(RAP) was defined as repeat endotracheal intubation in the PACU after planned extubation of the initial endotracheal intubation for general anesthesia or combined general anesthesia other than that performed in the operating room.

repeat endotracheal intubation

Intervention Type PROCEDURE

repeat endotracheal intubation in the PACU after planned extubation of the initial endotracheal intubation for general anesthesia or combined general anesthesia other than that performed in the operating room

matched group

Patients without RAP during the PACU stay were designated as the matched group

No interventions assigned to this group

Interventions

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repeat endotracheal intubation

repeat endotracheal intubation in the PACU after planned extubation of the initial endotracheal intubation for general anesthesia or combined general anesthesia other than that performed in the operating room

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients requiring stay in PACU

Exclusion Criteria

* Patients were transferred directly from the operating room to the ward or icu
* non-postoperative patient
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shangkun Liu (200966)

OTHER

Sponsor Role lead

Responsible Party

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Shangkun Liu (200966)

nurse manager

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Hui Xu

Role: STUDY_CHAIR

Tongji Hospital

References

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American Society of Anesthesiologists Task Force on Postanesthetic Care. Practice guidelines for postanesthetic care: a report by the American Society of Anesthesiologists Task Force on Postanesthetic Care. Anesthesiology. 2002 Mar;96(3):742-52. doi: 10.1097/00000542-200203000-00033. No abstract available.

Reference Type BACKGROUND
PMID: 11873052 (View on PubMed)

Tarrac SE. A description of intraoperative and postanesthesia complication rates. J Perianesth Nurs. 2006 Apr;21(2):88-96. doi: 10.1016/j.jopan.2006.01.006.

Reference Type BACKGROUND
PMID: 16600829 (View on PubMed)

Siddiqui N, Arzola C, Teresi J, Fox G, Guerina L, Friedman Z. Predictors of desaturation in the postoperative anesthesia care unit: an observational study. J Clin Anesth. 2013 Dec;25(8):612-7. doi: 10.1016/j.jclinane.2013.04.018. Epub 2013 Oct 4.

Reference Type BACKGROUND
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Rujirojindakul P, Geater AF, McNeil EB, Vasinanukorn P, Prathep S, Asim W, Naklongdee J. Risk factors for reintubation in the post-anaesthetic care unit: a case-control study. Br J Anaesth. 2012 Oct;109(4):636-42. doi: 10.1093/bja/aes226. Epub 2012 Jul 9.

Reference Type BACKGROUND
PMID: 22777658 (View on PubMed)

Haritos G, Smith CA, Haas RE, Becker A, Nguyen D, Stierer KA, Klein M. Critical Events Leading to Endotracheal Reintubation in the Postanesthesia Care Unit: A Retrospective Inquiry of Contributory Factors. AANA J. 2019 Feb;87(1):59-63.

Reference Type BACKGROUND
PMID: 31587745 (View on PubMed)

Lee PJ, MacLennan A, Naughton NN, O'Reilly M. An analysis of reintubations from a quality assurance database of 152,000 cases. J Clin Anesth. 2003 Dec;15(8):575-81. doi: 10.1016/j.jclinane.2003.03.006.

Reference Type BACKGROUND
PMID: 14724078 (View on PubMed)

Bruins SD, Leong PM, Ng SY. Retrospective review of critical incidents in the post-anaesthesia care unit at a major tertiary hospital. Singapore Med J. 2017 Aug;58(8):497-501. doi: 10.11622/smedj.2016126. Epub 2016 Jul 21.

Reference Type BACKGROUND
PMID: 27439784 (View on PubMed)

Ting PC, Chou AH, Yang MW, Ho AC, Chang CJ, Chang SC. Postoperative reintubation after planned extubation: a review of 137,866 general anesthetics from 2005 to 2007 in a Medical Center of Taiwan. Acta Anaesthesiol Taiwan. 2010 Dec;48(4):167-71. doi: 10.1016/j.aat.2010.12.003. Epub 2010 Dec 22.

Reference Type BACKGROUND
PMID: 21195986 (View on PubMed)

Siao-feng A, Tai-di Z, OU QH. Risk factors for postoperative reintubation in patients undergoing general anesthesia. Chin J Anesthesiol. 2013;33(12):1427-30.

Reference Type BACKGROUND

Beverly A, Brovman EY, Malapero RJ, Lekowski RW, Urman RD. Unplanned Reintubation Following Cardiac Surgery: Incidence, Timing, Risk Factors, and Outcomes. J Cardiothorac Vasc Anesth. 2016 Dec;30(6):1523-1529. doi: 10.1053/j.jvca.2016.05.033. Epub 2016 May 21.

Reference Type BACKGROUND
PMID: 27595531 (View on PubMed)

Menon N, Joffe AM, Deem S, Yanez ND, Grabinsky A, Dagal AH, Daniel S, Treggiari MM. Occurrence and complications of tracheal reintubation in critically ill adults. Respir Care. 2012 Oct;57(10):1555-63. doi: 10.4187/respcare.01617. Epub 2012 Feb 10.

Reference Type BACKGROUND
PMID: 22324979 (View on PubMed)

Ing C, Chui I, Ohkawa S, Kakavouli A, Sun L. Incidence and causes of perioperative endotracheal reintubation in children: a review of 28,208 anesthetics. Paediatr Anaesth. 2013 Jul;23(7):621-6. doi: 10.1111/j.1460-9592.2012.03920.x. Epub 2012 Jul 23.

Reference Type BACKGROUND
PMID: 22817271 (View on PubMed)

De la Garza Ramos R, Passias PG, Schwab F, Bydon A, Lafage V, Sciubba DM. Incidence, Risk Factors, and Mortality of Reintubation in Adult Spinal Deformity Surgery. Clin Spine Surg. 2017 Aug;30(7):E896-E900. doi: 10.1097/BSD.0000000000000404.

Reference Type BACKGROUND
PMID: 27352366 (View on PubMed)

Gao F, Yang LH, He HR, Ma XC, Lu J, Zhai YJ, Guo LT, Wang X, Zheng J. The effect of reintubation on ventilator-associated pneumonia and mortality among mechanically ventilated patients with intubation: A systematic review and meta-analysis. Heart Lung. 2016 Jul-Aug;45(4):363-71. doi: 10.1016/j.hrtlng.2016.04.006.

Reference Type BACKGROUND
PMID: 27377334 (View on PubMed)

Liu SK, Chen G, Yan B, Huang J, Xu H. Adverse Respiratory Events Increase Post-anesthesia Care Unit Stay in China: A 2-year Retrospective Matched Cohort Study. Curr Med Sci. 2019 Apr;39(2):325-329. doi: 10.1007/s11596-019-2038-y. Epub 2019 Apr 23.

Reference Type RESULT
PMID: 31016529 (View on PubMed)

Other Identifiers

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TJ-IRB20170501

Identifier Type: -

Identifier Source: org_study_id

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