دورية أكاديمية

Long-Term Outcomes of Cricothyroidotomy Versus Endotracheal Intubation in Military Personnel: A Retrospective Comparative Analysis Cohort Study.

التفاصيل البيبلوغرافية
العنوان: Long-Term Outcomes of Cricothyroidotomy Versus Endotracheal Intubation in Military Personnel: A Retrospective Comparative Analysis Cohort Study.
المؤلفون: Tsur N; The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel; Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Tel Aviv University, Petach Tiqva, Israel. Electronic address: nirtsur19@gmail.com., Talmy T; The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel; The Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel., Rittblat M; The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel; The Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel., Radomislensky I; The National Center for Trauma & Emergency Medicine Research, Gertner Institute, Ramat-Gan, Israel., Almog O; The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel; The Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel., Gendler S; The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.
المصدر: The Journal of surgical research [J Surg Res] 2024 Aug; Vol. 300, pp. 416-424. Date of Electronic Publication: 2024 Jun 07.
نوع المنشور: Journal Article; Comparative Study
اللغة: English
بيانات الدورية: Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
مواضيع طبية MeSH: Intubation, Intratracheal*/statistics & numerical data , Intubation, Intratracheal*/adverse effects , Intubation, Intratracheal*/methods , Military Personnel*/statistics & numerical data , Cricoid Cartilage*/surgery, Humans ; Retrospective Studies ; Male ; Adult ; Female ; Israel/epidemiology ; Airway Management/methods ; Airway Management/statistics & numerical data ; Treatment Outcome ; Young Adult ; Thyroid Cartilage/surgery ; Emergency Medical Services/statistics & numerical data ; Registries/statistics & numerical data ; Middle Aged ; Follow-Up Studies
مستخلص: Introduction: Emergency airway management is critical in trauma care. Cricothyroidotomy (CRIC) is a salvage procedure commonly used in failed endotracheal intubation (ETI) or difficult airway cases. However, more data is needed regarding the short and long-term complications associated with CRIC. This study aimed to evaluate the Israel Defense Forces experience with CRIC over the past 2 decades and compare the short-term and long-term sequelae of prehospital CRIC and ETI.
Methods: Data on patients undergoing either CRIC or ETI in the prehospital setting between 1997 and 2021 were extracted from the Israel Defense Forces trauma registry. Patient data was then cross-referenced with the Israel national trauma registry, documenting in-hospital care, and the Israel Ministry of Defense rehabilitation department registry, containing long-term disability files of military personnel.
Results: Of the 122 patients with short-term follow-up through initial hospitalization, 81% underwent prehospital ETI, while 19% underwent CRIC. There was a higher prevalence of military-related and explosion injuries among the CRIC patients (96% versus 65%, P = 0.02). Patients who underwent CRIC more frequently exhibited oxygen saturations below 90% (52% versus 29%, P = 0.002). Injury Severity Score was comparable between groups.No significant difference was found in intensive care unit length of stay and need for tracheostomy. Regarding long-term complications, with a median follow-up time of 15 y, CRIC patients had more upper airway impairment, with most suffering from hoarseness alone. One patient in the CRIC group suffered from esophageal stricture.
Conclusions: This retrospective comparative analysis did not reveal significant short or long-term sequelae among military personnel who underwent prehospital CRIC. The long-term follow-up did not indicate severe aerodigestive impairments, thus suggesting that this technique is safe. Along with the high success rates attributed to this procedure, we recommend that CRIC remains in the armamentarium of trauma care providers. The findings of this study could provide valuable insights into managing difficult airway in trauma care and inform clinical decision-making in emergency settings.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
التعليقات: Erratum in: J Surg Res. 2024 Sep;301:247. doi: 10.1016/j.jss.2024.06.004. (PMID: 38970872)
فهرسة مساهمة: Keywords: Cricothyroidotomy; Long-term outcomes; Surgical airway; Trauma; Upper aerodigestive
تواريخ الأحداث: Date Created: 20240608 Date Completed: 20240714 Latest Revision: 20240926
رمز التحديث: 20240927
DOI: 10.1016/j.jss.2024.05.015
PMID: 38851087
قاعدة البيانات: MEDLINE
الوصف
تدمد:1095-8673
DOI:10.1016/j.jss.2024.05.015