| Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. | |
| | |
MedLine Citation:
|
PMID: 21447488 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: This project was devised to estimate the incidence of major complications of airway management during anaesthesia in the UK and to study these events. METHODS: Reports of major airway management complications during anaesthesia (death, brain damage, emergency surgical airway, unanticipated intensive care unit admission) were collected from all National Health Service hospitals for 1 yr. An expert panel assessed inclusion criteria, outcome, and airway management. A matched concurrent census estimated a denominator of 2.9 million general anaesthetics annually. RESULTS: Of 184 reports meeting inclusion criteria, 133 related to general anaesthesia: 46 events per million general anaesthetics [95% confidence interval (CI) 38-54] or one per 22,000 (95% CI 1 per 26-18,000). Anaesthesia events led to 16 deaths and three episodes of persistent brain damage: a mortality rate of 5.6 per million general anaesthetics (95% CI 2.8-8.3): one per 180,000 (95% CI 1 per 352-120,000). These estimates assume that all such cases were captured. Rates of death and brain damage for different airway devices (facemask, supraglottic airway, tracheal tube) varied little. Airway management was considered good in 19% of assessable anaesthesia cases. Elements of care were judged poor in three-quarters: in only three deaths was airway management considered exclusively good. CONCLUSIONS: Although these data suggest the incidence of death and brain damage from airway management during general anaesthesia is low, statistical analysis of the distribution of reports suggests as few as 25% of relevant incidents may have been reported. It therefore provides an indication of the lower limit for incidence of such complications. The review of airway management indicates that in a majority of cases, there is 'room for improvement'. |
| | |
Authors:
|
T M Cook; N Woodall; C Frerk; |
Related Documents
:
|
16713158 - Some unique ethnomedicinal uses of plants used by the korku tribe of amravati district ... 2598328 - Saponins from leaves of kalopanax pictum var. maximowiczii, a korean medicinal plant. 17652338 - In situ management and domestication of plants in mesoamerica. 17943898 - Chinese herbal medicines in the treatment of ectopic pregnancy. 19547728 - Malposition of percutaneous endoscopic-guided gastrostomy: guideline and management. 7067498 - The office treatment of minor chemical skin burns. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-03-29 |
Journal Detail:
|
Title: British journal of anaesthesia Volume: 106 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2011 May |
Date Detail:
|
Created Date: 2011-04-18 Completed Date: 2011-06-23 Revised Date: 2011-10-17 |
Medline Journal Info:
|
Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
|
Languages: eng Pagination: 617-31 Citation Subset: IM |
Affiliation:
|
Department of Anaesthesia, Royal United Hospital, Combe Park, Bath BA1 3NG, UK. timcook007@googlemail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Airway Management / adverse effects*, methods, mortality Airway Obstruction / epidemiology, etiology, surgery Anesthesia, General / adverse effects*, mortality Child Emergencies Female Great Britain / epidemiology Humans Hypoxia, Brain / epidemiology, etiology Intensive Care Units / statistics & numerical data Male Medical Audit Middle Aged Prospective Studies State Medicine / statistics & numerical data |
| Comments/Corrections | |
Comment In:
|
Br J Anaesth. 2011 Oct;107(4):636; author reply 636-8
[PMID:
21903644
]
Br J Anaesth. 2011 Sep;107(3):470; author reply 471 [PMID: 21841051 ] Br J Anaesth. 2011 Sep;107(3):473; author reply 473 [PMID: 21841055 ] Br J Anaesth. 2011 Aug;107(2):272-3; author reply 273 [PMID: 21757550 ] Br J Anaesth. 2011 Sep;107(3):472; author reply 472-3 [PMID: 21841053 ] Br J Anaesth. 2011 May;106(5):613-6 [PMID: 21498493 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Effects of propofol on the expression of matric metalloproteinases in rat cardiac fibroblasts after ...
Next Document: Major complications of airway management in the UK: results of the Fourth National Audit Project of ...