tetano
Editor, Senior Moderator
J Crit Care
. 2022 May 16;71:154062.
doi: 10.1016/j.jcrc.2022.154062. Online ahead of print.
Association between timing of intubation and clinical outcomes of critically ill patients: A meta-analysis
Nikoleta A Xixi[SUP] 1 [/SUP], Panagiotis Kremmydas[SUP] 1 [/SUP], Eleni Xourgia[SUP] 1 [/SUP], Vassiliki Giannopoulou[SUP] 1 [/SUP], Katerina Sarri[SUP] 1 [/SUP], Ilias I Siempos[SUP] 2 [/SUP]
Affiliations
Abstract
Purpose: Optimal timing of intubation is controversial. We attempted to investigate the association between timing of intubation and clinical outcomes of critically ill patients.
Methods: PubMed was systematically searched for studies reporting on mortality of critically ill patients undergoing early versus late intubation. Studies involving patients with new coronavirus disease (COVID-19) were excluded because a relevant meta-analysis has been published. "Early" intubation was defined according to the authors of the included studies. All-cause mortality was the primary outcome. Pooled risk ratio (RR) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO (CRD42021284850).
Results: In total, 27 studies involving 15,441 intubated patients (11,943 early, 3498 late) were included. All-cause mortality was lower in patients undergoing early versus late intubation (7338 deaths; 45.8% versus 53.5%; RR 0.92, 95% CI 0.87-0.97; p = 0.001). This was also the case in the sensitivity analysis of studies defining "early" as intubation within 24 h from admission in the intensive care unit (6279 deaths; 45.8% versus 53.6%; RR 0.93, 95% CI 0.89-0.98; p = 0.005).
Conclusion: Avoiding late intubation may be associated with lower mortality in critically ill patients without COVID-19.
Keywords: Acute respiratory distress syndrome; Intensive care unit; Intubation timing; Invasive mechanical ventilation; Respiratory failure.
. 2022 May 16;71:154062.
doi: 10.1016/j.jcrc.2022.154062. Online ahead of print.
Association between timing of intubation and clinical outcomes of critically ill patients: A meta-analysis
Nikoleta A Xixi[SUP] 1 [/SUP], Panagiotis Kremmydas[SUP] 1 [/SUP], Eleni Xourgia[SUP] 1 [/SUP], Vassiliki Giannopoulou[SUP] 1 [/SUP], Katerina Sarri[SUP] 1 [/SUP], Ilias I Siempos[SUP] 2 [/SUP]
Affiliations
- PMID: 35588639
- DOI: 10.1016/j.jcrc.2022.154062
Abstract
Purpose: Optimal timing of intubation is controversial. We attempted to investigate the association between timing of intubation and clinical outcomes of critically ill patients.
Methods: PubMed was systematically searched for studies reporting on mortality of critically ill patients undergoing early versus late intubation. Studies involving patients with new coronavirus disease (COVID-19) were excluded because a relevant meta-analysis has been published. "Early" intubation was defined according to the authors of the included studies. All-cause mortality was the primary outcome. Pooled risk ratio (RR) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO (CRD42021284850).
Results: In total, 27 studies involving 15,441 intubated patients (11,943 early, 3498 late) were included. All-cause mortality was lower in patients undergoing early versus late intubation (7338 deaths; 45.8% versus 53.5%; RR 0.92, 95% CI 0.87-0.97; p = 0.001). This was also the case in the sensitivity analysis of studies defining "early" as intubation within 24 h from admission in the intensive care unit (6279 deaths; 45.8% versus 53.6%; RR 0.93, 95% CI 0.89-0.98; p = 0.005).
Conclusion: Avoiding late intubation may be associated with lower mortality in critically ill patients without COVID-19.
Keywords: Acute respiratory distress syndrome; Intensive care unit; Intubation timing; Invasive mechanical ventilation; Respiratory failure.