Rapid sequence induction: An international survey.
Journal
European journal of anaesthesiology
ISSN: 1365-2346
Titre abrégé: Eur J Anaesthesiol
Pays: England
ID NLM: 8411711
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
pubmed:
30
3
2020
medline:
28
4
2021
entrez:
30
3
2020
Statut:
ppublish
Résumé
Rapid sequence induction (RSI) is a standard procedure, which should be implemented in all patients with a risk of aspiration/regurgitation during anaesthesia induction. The primary aim was to evaluate clinical practice in RSI, both in adult and paediatric populations. Online survey. A total of 56 countries. Members of the European Society of Anaesthesiology. The aim was to identify and describe the actual clinical practice of RSI related to general anaesthesia. From the 1921 respondents, 76.5% (n=1469) were qualified anaesthesiologists. When anaesthetising adults, the majority (61.7%, n=1081) of the respondents preoxygenated patients with 100% O2 for 3 min and 65.9% (n=1155) administered opioids during RSI. The Sellick manoeuvre was used by 38.5% (n=675) and was not used by 37.4% (n=656) of respondents. First-line medications for a haemodynamically stable adult patient were propofol (90.6%, n=1571) and suxamethonium (56.0%, n=932). Manual ventilation (inspiratory pressure <12 cmH2O) was used in 35.5% (n=622) of respondents. In the majority of paediatric patients, 3 min of preoxygenation (56.6%, n=817) and opioids (54.9%, n=797) were administered. The Sellick manoeuvre and manual ventilation (inspiratory pressure <12 cmH2O) in children were used by 23.5% (n=340) and 35.9% (n=517) of respondents, respectively. First-line induction drugs for a haemodynamically stable child were propofol (82.8%, n=1153) and rocuronium (54.7%, n=741). We found significant heterogeneity in the daily clinical practice of RSI. For patient safety, our findings emphasise the need for international RSI guidelines. ClinicalTrials.gov identifier: NCT03694860.
Sections du résumé
BACKGROUND
Rapid sequence induction (RSI) is a standard procedure, which should be implemented in all patients with a risk of aspiration/regurgitation during anaesthesia induction.
OBJECTIVE
The primary aim was to evaluate clinical practice in RSI, both in adult and paediatric populations.
DESIGN
Online survey.
SETTINGS
A total of 56 countries.
PARTICIPANTS
Members of the European Society of Anaesthesiology.
MAIN OUTCOME MEASURES
The aim was to identify and describe the actual clinical practice of RSI related to general anaesthesia.
RESULTS
From the 1921 respondents, 76.5% (n=1469) were qualified anaesthesiologists. When anaesthetising adults, the majority (61.7%, n=1081) of the respondents preoxygenated patients with 100% O2 for 3 min and 65.9% (n=1155) administered opioids during RSI. The Sellick manoeuvre was used by 38.5% (n=675) and was not used by 37.4% (n=656) of respondents. First-line medications for a haemodynamically stable adult patient were propofol (90.6%, n=1571) and suxamethonium (56.0%, n=932). Manual ventilation (inspiratory pressure <12 cmH2O) was used in 35.5% (n=622) of respondents. In the majority of paediatric patients, 3 min of preoxygenation (56.6%, n=817) and opioids (54.9%, n=797) were administered. The Sellick manoeuvre and manual ventilation (inspiratory pressure <12 cmH2O) in children were used by 23.5% (n=340) and 35.9% (n=517) of respondents, respectively. First-line induction drugs for a haemodynamically stable child were propofol (82.8%, n=1153) and rocuronium (54.7%, n=741).
CONCLUSION
We found significant heterogeneity in the daily clinical practice of RSI. For patient safety, our findings emphasise the need for international RSI guidelines.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT03694860.
Identifiants
pubmed: 32221099
doi: 10.1097/EJA.0000000000001194
pmc: PMC7259384
pii: 00003643-202006000-00002
doi:
Substances chimiques
Succinylcholine
J2R869A8YF
Banques de données
ClinicalTrials.gov
['NCT03694860']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
435-442Commentaires et corrections
Type : CommentIn
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