Retrospective Analysis of Peri-Intubation Hypoxemia During the Coronavirus Disease 2019 Epidemic Using a Protocol for Modified Airway Management

A A Pract. 2020 Dec 17;14(14):e01360. doi: 10.1213/XAA.0000000000001360.

Abstract

This single-center retrospective study evaluated a protocol for the intubation of patients with confirmed or suspected coronavirus disease 2019 (COVID-19). Twenty-one patients were intubated, 9 of whom were found to have COVID-19. Adherence to the airway management protocol was high. COVID-19 patients had lower peripheral capillary oxygen saturation by pulse oximetry (Spo2) nadirs during intubation (Spo2, 73% [72%-77%] vs 89% [86%-94%], P = .024), and a greater percentage experienced severe hypoxemia defined as Spo2 ≤80% (89% vs 25%, P = .008). The incidence of severe hypoxemia in COVID-19 patients should be considered in the development of guidelines that incorporate high-flow nasal cannula and noninvasive positive pressure ventilation.

MeSH terms

  • Adult
  • Aged
  • Airway Management
  • COVID-19 / therapy*
  • Cannula
  • Female
  • Humans
  • Hypoxia / prevention & control
  • Hypoxia / therapy*
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Intubation, Intratracheal / methods*
  • Laryngoscopy
  • Male
  • Middle Aged
  • N95 Respirators
  • Noninvasive Ventilation
  • Oximetry
  • Oxygen Inhalation Therapy
  • Patient Isolators
  • Personal Protective Equipment
  • Positive-Pressure Respiration
  • Practice Guidelines as Topic
  • Rapid Sequence Induction and Intubation / methods*
  • Respiratory Insufficiency / therapy*
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index