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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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miércoles, 25 de enero de 2017

Whether to Intubate During CPR

Angus D. JAMA. Published online January 24, 2017- doi:10.1001/jama.2016.20626
...So, should clinicians conclude that early intubation is harmful or, at least, ineffective and unnecessary? The act of intubation, especially in skilled hands, should not directly cause injury or death. However, distraction from effective chest compressions while intubation is performed could certainly be harmful. Intubation may also facilitate provision of higher oxygen concentrations, which have been associated with harm. Moreover, patients in the “maybe later” group who recover without any intubation avoid the multiple potential complications of prolonged mechanical ventilation. But, an alternative explanation is that patients who were intubated had greater illness severity in ways for which the design did not account, despite the richness of the data. It is also possible that hospitals or physicians and other members of the resuscitation team with greater propensity to intubate patients are also more likely to provide other therapies or interventions that may inadvertently cause harm. The data set did not allow the authors to explore these possibilities more thoroughly..."