TABLE 1.
Clinical Characteristics of the Three Airway Groupsa
| Characteristics | None (n = 762) | First Success (n = 1,185) | First Failure (n = 263) | p |
|---|---|---|---|---|
| Patient illness category, n (%) | < 0.0001 | |||
| Medical cardiac | 67 (9) | 110 (9) | 21 (8) | |
| Medical noncardiac | 451 (59) | 593 (50) | 143 (54) | |
| Surgical cardiac | 46 (6) | 101 (9) | 17 (6) | |
| Surgical noncardiac | 92 (12) | 120 (10) | 24 (9) | |
| Newborn | 94 (12) | 167 (14) | 43 (16) | |
| Obstetric | 1 (0) | 1 (0) | 1 (0) | |
| Trauma | 9 (1) | 87 (7) | 12 (5) | |
| Other or unknown | 2 (0) | 6 (1) | 2 (1) | |
| Preexisting medical conditions, n (%) | ||||
| None | 335 (49) | 356 (36) | 99 (41) | < 0.0001 |
| Acute central nervous system nonstroke event | 85 (12) | 147 (15) | 23 (9) | 0.071 |
| Acute stroke | 4 (1) | 7 (1) | 3 (1) | 0.69 |
| Acyanotic cardiac malformation | 36 (5) | 66 (7) | 16 (7) | 0.49 |
| Cyanotic cardiac malformation | 55 (8) | 90 (9) | 19 (8) | 0.71 |
| Noncardiac congenital malformation | 115 (17) | 108 (11) | 26 (11) | 0.0009 |
| Congestive heart failure | 22 (3) | 46 (5) | 9 (4) | 0.35 |
| Hypotension/hypoperfusion | 23 (3) | 97 (10) | 10 (4) | < 0.0001 |
| Major trauma | 7 (1) | 91 (9) | 12 (5) | < 0.0001 |
| Pneumonia | 50 (9) | 93 (9) | 31 (13) | 0.12 |
| Septicemia | 36 (5) | 100 (10) | 26 (11) | 0.0009 |
| Interventions already in place, n (%) | ||||
| Electrocardiogram | 479 (63) | 888 (75) | 198 (75) | < 0.0001 |
| Pulse oximeter | 566 (74) | 965 (81) | 219 (83) | 0.0002 |
| Supplemental oxygen | 326 (46) | 625 (59) | 138 (57) | < 0.0001 |
| Location of event, n (%) | <0.0001 | |||
| ICU | 90 (12) | 419 (35) | 79 (30) | |
| Emergency department | 45 (6) | 249 (21) | 63 (24) | |
| General inpatient area | 484 (64) | 317 (27) | 62 (24) | |
| Neonatal ICU | 30 (4) | 87 (7) | 36 (14) | |
| Procedural area/operating room | 79 (10) | 64 (5) | 12 (5) | |
| Other | 32 (4) | 47 (4) | 4 (2) | |
| Breathing at the time of event, n (%) | < 0.0001 | |||
| Yes | 378 (50) | 616 (52) | 156 (59) | |
| No | 236 (31) | 218 (18) | 44 (17) | |
| Agonal | 68 (9) | 137 (12) | 29 (11) | |
| Assisted noninvasive ventilation | 46 (6) | 137 (12) | 25 (10) | |
| Unknown | 34 (4) | 77 (6) | 9 (3) | |
| Hospital-wide response?, n (%) | ||||
| Yes | 539 (71) | 479 (40) | 106 (40) | < 0.0001 |
| Ventilation during event, n (%) | ||||
| Bag-valve-mask | 624 (82) | 1,050 (89) | 244 (93) | < 0.0001 |
| Continuous positive airway pressure/bilevel positive airway pressure | 250 (33) | 122 (10) | 21 (8) | < 0.0001 |
| Other noninvasive ventilation | 26 (3) | 17 (1) | 10 (4) | 0.0059 |
| Pharmacologic interventions, n (%) | ||||
| Bronchodilator | 57 (7) | 63 (5) | 19 (7) | 0.13 |
| Calcium | 9 (1) | 54 (5) | 5 (2) | < 0.0001 |
| Fluid bolus | 97 (13) | 272 (23) | 72 (27) | < 0.0001 |
| Neuromuscular blockade | 10 (1) | 580 (49) | 116 (44) | < 0.0001 |
| Reversal agent | 46 (6) | 29 (2) | 4 (2) | < 0.0001 |
| Sedative/induction agent | 61 (8) | 741 (63) | 171 (65) | < 0.0001 |
| Sodium bicarbonate | 14 (2) | 94 (8) | 15 (6) | < 0.0001 |
| Other | 122 (16) | 355 (30) | 88 (33) | < 0.0001 |
| Nonpharmacologic interventions, n (%) | ||||
| Central venous line | 6 (1) | 68 (6) | 14 (5) | < 0.0001 |
| Chest tube | 3 (0) | 17 (1) | 5 (2) | 0.049 |
| Event outcomeb, n (%) | < 0.0001 | |||
| Return of spontaneous ventilation | 531 (70) | 23 (2) | 10 (4) | |
| Controlled with assisted ventilation | 175 (23) | 1,025 (86) | 208 (79) | |
| Oardiopulmonary arrest, n (%) | 56 (7) | 137 (12) | 45 (17) | |
| Discharge disposition, n (%) | < 0.0001 | |||
| Survivor | 663 (88) | 926 (78) | 208 (80) | |
| Nonsurvivorc | 71 (9) | 230 (19) | 47 (18) |
a
”None” is no invasive airway required, “First Success” is successful first attempt intubation, and “First Failure” is any event that had > 1 attempt at tracheal intubation, a laryngeal mask airway placement, or the creation of a new tracheostomy or cricothyrotomy.
b
Excludes 11 patients with do-not-resuscitate orders.
c
Fifty-two patients listed as pending hospital discharge.