A prospective, cohort evaluation of major and minor airway management complications during routine anaesthetic care at an academic medical centre

Anaesthesia. 2017 Jan;72(1):42-48. doi: 10.1111/anae.13640. Epub 2016 Sep 26.

Abstract

The aim of this study was to develop an audit tool to identify prospectively all peri-operative adverse events during airway management in a cost-effective and reproducible way. All patients at VU University Medical Center who required general anaesthesia for elective and emergency surgical procedures were included during a period of 8 weeks. Daily questionnaires and interviews were taken from anaesthesia trainees and anaesthetic department staff members. A total of 2803 patients underwent general anaesthesia, 1384 men and 1419 women, including 2232 elective patients and 571 emergency procedures, 697 paediatric and 2106 adult surgical procedures. A total of 168 airway-related events were reported. The incidence of severe airway management-related events was 24/2803 (0.86%). There were 12 (0.42%) unanticipated ICU admissions, two patients (0.07%) required a surgical airway. There was one (0.04%) death, one cannot intubate cannot oxygenate (0.04%), one aspiration (0.04%) and eight (0.29%) severe desaturations < Sp O2 50%. We suggest that our method to determine and investigate airway management-related adverse events could be adopted by other hospitals.

Keywords: airway management; brain damage; complications; emergency surgical airway; general anaesthesia; serious adverse events.

Publication types

  • Observational Study

MeSH terms

  • Academic Medical Centers
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Airway Management / adverse effects*
  • Airway Management / methods
  • Anesthesia, General / adverse effects*
  • Anesthesia, General / methods
  • Child
  • Female
  • Humans
  • Hypoxia / etiology
  • Intensive Care Units / statistics & numerical data
  • Intraoperative Complications / etiology
  • Male
  • Medical Audit / methods
  • Middle Aged
  • Netherlands
  • Patient Admission / statistics & numerical data
  • Postoperative Complications / etiology
  • Prospective Studies
  • Severity of Illness Index
  • Young Adult