Devendra Prasad K.J.1, Biju Shekar2
BACKGROUND
First-pass success is the successful intubation on the first attempt. It is the desired
goal of emergency intubation and failure to achieve it may increase the risk of
adverse effects. With failure of first pass intubation, life-threatening complications
occur, commonly in critically ill patients. The aim of this study is to determine the
association between the success of first-pass intubation and frequency of adverse
events during endotracheal intubation.
METHODS
A cross sectional analytical study was done in a tertiary care hospital between
October 2016 and October 2017. 100 failed first-pass intubation cases and 100
successful first-pass intubation cases were evaluated for factors associated with
failed first-pass intubation and frequency of adverse events following intubation.
RESULTS
The groups were matched with respect to gender, induction agent use, fentanyl
use and type of laryngoscope used. Mean age in failed first-pass intubation group
was 5.61 years higher than subjects in successful first-pass intubation group (P =
0.016). Proportion of subjects with difficult airway was 19 % in failed first-pass
intubation group and 3 % in successful first-pass intubation (P < 0.001). Failed
first-pass intubation cases had higher frequency of adverse events like
oesophageal intubation (9 % vs. 0 %), aspiration (7 % vs. 1 %), cuff leakage (2
% vs. 0 %) and hypotension (7 % vs. 1 %) compared to successful first-pass
intubation cases.
CONCLUSIONS
The frequency of adverse events was high in failed first-pass intubation. Older age
and presence of difficult airway were factors significantly associated with failed
first-pass intubation.
