Table 2.
Airway management of patients infected with coronavirus disease 2019 from two hospitals in Wuhan, China. Data are presented as n (%). Proportions were analysed using χ2 test or Fisher's exact test. PAPR, powered air-purifying respirator.
| Characteristics | Total (n=202) | Hospital A (n=137) | Hospital B (n=65) | P-value |
|---|---|---|---|---|
| Before intubation | ||||
| Physical status during oxygen therapy | ||||
| Sao2 <90% | 152 (75.2) | 106 (77.4) | 46 (70.8) | 0.310 |
| Pao2/Fio2 <150 mm Hg | 194 (96.0) | 130 (94.9) | 64 (98.5) | 0.407 |
| Ventilatory frequency >30 bpm | 109 (54) | 69 (50.4) | 40 (61.5) | 0.137 |
| BP <90/60 mm Hg | 16 (7.9) | 14 (10.2) | 2 (3.1) | 0.079 |
| HR >120 beats min−1 | 49 (24.3) | 27 (19.7) | 22 (33.8) | 0.029 |
| Unconsciousness | 26 (12.9) | 14 (10.2) | 12 (18.5) | 0.102 |
| Oxygen therapy technique | ||||
| Regular nasal cannula | 8 (4.0) | 6 (4.4) | 2 (3.1) | 0.954 |
| Mask with reservoir bag | 21 (10.4) | 14 (10.2) | 7 (10.8) | 0.905 |
| High-flow nasal cannula | 28 (13.9) | 16 (11.7) | 12 (18.5) | 0.192 |
| Noninvasive ventilation | 143 (70.8) | 101 (73.7) | 42 (64.6) | 0.184 |
| Operator personal protective equipment | ||||
| Respirator (N95 or equivalent, inside) | 202 (100) | 137 (100) | 65 (100) | — |
| Surgical mask (outside) | 202 (100) | 137 (100) | 65 (100) | — |
| Goggles | 202 (100) | 137 (100) | 65 (100) | — |
| Face shield | 22 (10.9) | 7 (5.1) | 15 (23.1) | <0.001 |
| Full hood without a PAPR | 130 (64.4) | 130 (94.9) | 0 (0) | <0.001 |
| PAPR | 50 (24.8) | 0 (0) | 50 (76.9) | <0.001 |
| Intubation hampered by mask fog | 11 (5.4) | 11 (8.0) | 0 (0) | 0.044 |
| Anti-fog treatment | 197 (97.5) | 132 (96.4) | 65 (100) | 0.282 |
| Anti-fog method | N/A | Liquid soap | Iodophor | — |
| Necessary individuals | N/A | 2 | 2 | — |
| Operator infection | 0 (0) | 0 (0%) | 0 (0) | — |
| Intubation | ||||
| Induction | ||||
| Bolus of i.v. fluid | 0 (0) | 0 (0) | 0 (0) | — |
| Prophylactic vasopressor | 41 (20.3) | 41 (29.9) | 0 (0) | <0.001 |
| Preoxygenate with 100% Fio2 for 5 min | 202 (100) | 137 (100) | 65 (100) | — |
| Preoxygenate via prior oxygen therapy | 107 (53.0) | 92 (67.2) | 15 (23.1) | <0.001 |
| Preoxygenate via face mask | 95 (47.0) | 45 (32.8) | 50 (76.9) | <0.001 |
| Propofol | 194 (96.0) | 135 (98.5) | 59 (90.8) | 0.024 |
| Etomidate | 6 (3.0) | 5 (3.6) | 1 (1.5) | 0.702 |
| Midazolam | 27 (13.4) | 27 (19.7) | 0 (0) | <0.001 |
| Sufentanil | 99 (49) | 94 (68.6) | 5 (7.7) | <0.001 |
| Fentanyl | 60 (29.7) | 6 (4.4) | 54 (83.1) | <0.001 |
| Rocuronium | 200 (99.0) | 137 (100) | 63 (96.9) | 0.102 |
| Mask ventilation after induction | 188 (93.1) | 123 (89.8) | 65 (100) | 0.018 |
| Intubation device at first attempt | ||||
| Macintosh laryngoscope | 21 (10.4) | 21 (15.3) | 0 (0) | 0.001 |
| Videolaryngoscope with disposable blade | 181 (89.6) | 116 (84.7) | 65 (100) | 0.001 |
| Results of intubation | ||||
| Successful intubation at first attempt | 180 (89.1) | 116 (84.7) | 64 (98.5) | 0.003 |
| Total successful intubation | 202 (100) | 137 (100) | 65 (100) | — |
| Duration of intubation ≤3 min | 187 (92.6) | 123 (89.8) | 64 (98.5) | 0.040 |
| Duration of intubation >3 min | 12 (5.9) | 11 (8) | 1 (1.5) | 0.108 |
| Duration of intubation >5 min | 3 (1.5) | 3 (2.2) | 0 (0) | 0.553 |
| Adverse events during intubation | ||||
| Hypoxaemia (Sao2 <90%) | 175 (73.3) | 110 (80.3) | 38 (58.5) | 0.001 |
| Hypotension (BP <90/60 mm Hg) | 36 (17.8) | 14 (10.2) | 22 (33.8) | <0.001 |
| After intubation | ||||
| Physical status | ||||
| Hypoxaemia (Sao2 <90%) | 36 (17.8) | 16 (11.7) | 20 (30.8) | 0.001 |
| Hypotension (BP <90/60 mm Hg) | 18 (27.7) | 27 (19.7) | 18 (27.7) | 0.203 |
| Cardiac arrest | 4 (2.0) | 0 (0) | 4 (6.2) | 0.017 |
| Ventilation and adverse events | ||||
| Prone ventilation | 67 (33.2) | 55 (40.1) | 12 (18.5) | 0.002 |
| Pneumothorax | 12 (5.9) | 6 (4.4) | 6 (9.2) | 0.296 |
| All-cause mortality within 24 h | 21 (10.4) | 11 (8.0) | 10 (15.4) | 0.110 |