Citation Information :
Divatia JV, Harish MM, Chaudhari H, Siddiqui SS, Janarthanan S, Prabu RN. Complications of tracheal intubation in critically ill pediatric cancer patients. Indian J Crit Care Med 2016; 20 (7):409-411.
Background and Aims: The oncologists are treating cancer more aggressively, leading to increase in number of pediatric admissions to the ICU. Due to anatomical and physiological differences, pediatric patients are at high risk of complications during intubation. We evaluated the incidence of complications during intubations in pediatric patients in our ICU.
Subjects and Methods: We performed retrospective analysis of complications occurring during intubation in 42 pediatric patients. All intubations were orotracheal. We recorded number of attempts at intubation, need for use of intubation adjuncts and complications during laryngoscopy and intubation. The incidence of difficult intubation, hypoxia, and severe cardiovascular collapse was also noted.
Results: Complications occurred during 13 (31%) intubations. Hypoxia and severe cardiovascular collapse occurred in during 7 (16.7%) intubations each, while 4 patients (9.5%) (n=4) had cardiac arrest during intubation. Thirty three (78.6%) intubations were successful in first attempt and difficult intubation was recorded in 4 patients.
Conclusion: Critically ill pediatric cancer patients have a high rate of complications during intubation.
Divatia JV, Bhowmick K. Complications of endotracheal intubation and other airway management procedures. Indian J Anaesth 2005;49:308-18.
Sanders RC Jr., Giuliano JS Jr., Sullivan JE, Brown CA 3 rd, Walls RM, Nadkarni V, et al. Level of trainee and tracheal intubation outcomes. Pediatrics 2013;131:e821-8.
Souza ND, Carvalho WB. Complications of tracheal intubation in pediatrics. Rev Assoc Med Bras 2009;55:646-50.
Mort TC. The incidence and risk factors for cardiac arrest during emergency tracheal intubation: A justification for incorporating the ASA Guidelines in the remote location. J Clin Anesth 2004;16:508-16.
Simpson GD, Ross MJ, McKeown DW, Ray DC. Tracheal intubation in the critically ill: A multi-centre national study of practice and complications. Br J Anaesth 2012;108:792-9.
Sapolnik R. Intensive care therapy for cancer patients. J Pediatr (Rio J) 2003;79 Suppl 2:S231-42.
Arora RS, Eden TO, Kapoor G. Epidemiology of childhood cancer in India. Indian J Cancer 2009;46:264-73.
von Bergwelt-Baildon M, Hallek MJ, Shimabukuro-Vornhagen AA, Kochanek M. CCC meets ICU: redefining the role of critical care of cancer patients. BMC Cancer 2010;10:612.
Zinter MS, DuBois SG, Spicer A, Matthay K, Sapru A. Pediatric cancer type predicts infection rate, need for critical care intervention, and mortality in the pediatric intensive care unit. Intensive Care Med 2014;40:1536-44.
El Halal MG, Barbieri E, Filho RM, Trotta Ede A, Carvalho PR. Admission source and mortality in a pediatric intensive care unit. Indian J Crit Care Med 2012;16:81-6.
Khositseth A, Anantasit N, Vaewpanich J. Deaths in a pediatric intensive care unit: A review over three years. Sri Lanka J Child Health 2012;41:166-70.
Sukys GA, Schvartsman C, Reis AG. Evaluation of rapid sequence intubation in the pediatric emergency department. J Pediatr (Rio J) 2011;87:343-9.
Nishisaki A, Ferry S, Colborn S, DeFalco C, Dominguez T, Brown CA 3 rd, et al. Characterization of tracheal intubation process of care and safety outcomes in a tertiary pediatric intensive care unit. Pediatr Crit Care Med 2012;13:e5-10.
Schwartz DE, Matthay MA, Cohen NH. Death and other complications of emergency airway management in critically ill adults. A prospective investigation of 297 tracheal intubations. Anesthesiology 1995;82:367-76.