ĐẶC ĐIỂM LÂM SÀNG, KỸ THUẬT VÀ CÁC BIẾN CỐ NGOẠI Ý KHI ĐẶT NỘI KHÍ QUẢN TẠI KHOA CẤP CỨU BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: Endotracheal intubation (ETI) is a common airway management procedure in emergency and critical care settings. Despite being life-saving, it carries a substantial risk of complications. Identifying clinical characteristics, procedural aspects, and factors associated with adverse events may help improve patient preparation and reduce complications. Objectives: To describe the clinical characteristics, intubation techniques, and adverse events associated with ETI in the Emergency Department. Methods: We conducted a prospective observational study including all patients undergoing ETI in the Emergency Department of University Medical Center Ho Chi Minh City from March 1, 2024, to February 28, 2025, excluding those intubated due to cardiac arrest. Results: A total of 249 patients were enrolled. The male-to-female ratio was approximately 1:1, and the mean age was 68.3 ± 17.21 years; 87.6% had at least one comorbidity. The most common indication for ETI was respiratory failure (41.8%). Preoxygenation was performed in all cases, sedatives in 86.7%, neuromuscular blocking agents in 83.9%, rapid sequence intubation in 77.1%, and video laryngoscopy in 96.4%. All patients were successfully intubated, with a first-pass success rate of 92.8%. The overall incidence of adverse events was 18.9%, most commonly hypotension (9.6%), cardiac arrest (4%) and mainstem bronchial intubation (2%). Conclusions: The first-pass success rate of ETI was high, but adverse events remained frequent. Hypotension and peri-intubation cardiac arrest were the most common complications. Preventive strategies and appropriate resuscitation measures are required.