KHẢO SÁT MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN 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 pivotal procedure in airway management in the emergency department (ED). However, ETI carries a substantial risk of major adverse events (MAEs), which can markedly influence patient outcomes. Therefore, identifying and analyzing risk factors associated with MAEs during ETI is crucial for optimizing procedural effectiveness and ensuring patient safety. ObjectiveTo investigate demographic, clinical, laboratory, and peri-procedural factors associated with MAEs during ETI. Methods We conducted a prospective observational study of patients undergoing ETI at the ED of the University Medical Center Ho Chi Minh City, excluding those with cardiac arrest, between March 1, 2024, and February 28, 2025. Results A total of 249 patients were enrolled, with a mean age of 68.3 ± 17.2 years. Overall, 18.9% experienced MAEs, primarily hypotension (9.6%), peri-intubation cardiac arrest (4.0%), and bradycardia (1.2%). Other complications included oropharyngeal or dental trauma (1.2%), esophageal intubation (0.8%), and mainstem intubation (2.8%). Univariate analyses identified several factors associated with MAEs, including chronic pulmonary disease, pre- and post-intubation systolic blood pressure (SBP), pre- and post-intubation diastolic blood pressure (DBP), and arterial blood gas parameters (pH, pCO₂). In multivariable logistic regression, two factors remained statistically significant: (1) post-intubation DBP (OR = 0.91; 95% CI: 0.88–0.94; p < 0.001), and (2) the interaction between operator experience and intubation duration (OR = 1.002; 95% CI: 1.002–1.004; p = 0.016). Conclusions: Post-intubation diastolic blood pressure and the combined effect of operator experience and intubation duration were strongly associated with the occurrence of MAEs. Continuous monitoring of hemodynamic parameters and optimization of procedural skills are essential to minimizing complications and improving the safety of ETI in the ED.