Tracheal Intubation in COVID-19 Patients
Study Details
Study Description
Brief Summary
The Emergency Endotracheal intubation of a patient who is COVID-19 positive is a high-risk procedure and an additional challenge to an intensivist due to barrier enclosures that have been developed to reduce the risk of COVID-19 transmission to healthcare providers during intubation. Although the incidence of difficult airways is commonly higher in critically ill patients, the evidence of severe hypoxemia without sign of respiratory distress could complicate the scenario.This silent hypoxia often leads to a delayed recognition of the severity of respiratory failure and to a late intubation which is often characterized by a high risk of complications related to the actual airways' management, hemodynamic and cardiac. It has been shown that non-survivors had worse blood gas analyzes than survivors, both before and after intubation. Few studies have reported the implications and adverse events of performing endotracheal intubation for critically ill COVID-19 patients admitted to intensive care units (ICUs).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Severe COVID pneumonia with ET Severe COVID 19 pneumonia undergoing endotracheal intubation |
Procedure: Endotracheal intubation
Airways management in COVID 19 patients pneumonia
|
Outcome Measures
Primary Outcome Measures
- Major adverse peri-intubation events [intubation procedure, an expected average 30 minutes]
The incidence of major adverse peri-intubation events defined as least one events: cardiovascular instability severe Hypoxemia cardiac arrest
Secondary Outcome Measures
- Number of minor complications in the intubation process in patients admitted in the intensive care [28 days]
This study will analyze the prevalence of minor complications related to intubation technique in the the Critical Unit. This information will be useful in order to determinate the risk factors associated.
- Correlation between videolaryngoscope use and incidence of complication compared to the conventional laryngoscopy [28 days]
Although the video laryngoscope is useful to perform difficult airways management, the benefits associated to its employment is still controversial compared to the conventional laringoscope.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Critically ill patient above 18 year old, admitted in the Intensive Care of San Bortolo Hospital, Vicenza, and San Matteo Hospital, Pavia;
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positive specimen for SARS-COV2 PCR;
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tracheal intubation for respiratory distress related to SARS COV2 pneumonia
Exclusion Criteria:
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negative specimen for SARS-COV2 PCR
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out of hospital intubation
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intubation during cardiac arrest
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intubation in the contest of general anesthesia for surgery
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | San Matteo Hospital | Pavia | Lombardia | Italy | 27100 |
| 2 | San Bortolo Hospital | Vicenza | Veneto | Italy | 36100 |
Sponsors and Collaborators
- St. Bortolo Hospital
- Fondazione IRCCS Policlinico San Matteo di Pavia
Investigators
- Principal Investigator: Lucia Cattin, MD, SBortolo Hospital
- Principal Investigator: Silvia De Rosa, MD, SBortolo Hospital
- Principal Investigator: Silvia Mongodi, MD, SMatteo Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Carrillo A, Gonzalez-Diaz G, Ferrer M, Martinez-Quintana ME, Lopez-Martinez A, Llamas N, Alcazar M, Torres A. Non-invasive ventilation in community-acquired pneumonia and severe acute respiratory failure. Intensive Care Med. 2012 Mar;38(3):458-66. doi: 10.1007/s00134-012-2475-6. Epub 2012 Feb 9.
- Goh KJ, Choong MC, Cheong EH, Kalimuddin S, Duu Wen S, Phua GC, Chan KS, Haja Mohideen S. Rapid Progression to Acute Respiratory Distress Syndrome: Review of Current Understanding of Critical Illness from Coronavirus Disease 2019 (COVID-19) Infection. Ann Acad Med Singap. 2020 Mar 16;49(3):108-118.
- Huang HB, Peng JM, Weng L, Liu GY, Du B. High-flow oxygen therapy in immunocompromised patients with acute respiratory failure: A review and meta-analysis. J Crit Care. 2018 Feb;43:300-305. doi: 10.1016/j.jcrc.2017.09.176. Epub 2017 Sep 22. Review.
- Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S. 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology. 2011 Jan;114(1):42-8. doi: 10.1097/ALN.0b013e318201c415.
- Yao W, Wang T, Jiang B, Gao F, Wang L, Zheng H, Xiao W, Yao S, Mei W, Chen X, Luo A, Sun L, Cook T, Behringer E, Huitink JM, Wong DT, Lane-Fall M, McNarry AF, McGuire B, Higgs A, Shah A, Patel A, Zuo M, Ma W, Xue Z, Zhang LM, Li W, Wang Y, Hagberg C, O'Sullivan EP, Fleisher LA, Wei H; collaborators. Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. Br J Anaesth. 2020 Jul;125(1):e28-e37. doi: 10.1016/j.bja.2020.03.026. Epub 2020 Apr 10.
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