Service Evaluation of the Impact of Capnography on the Safety of Procedural Sedation

Frontiers in Medicine

Amit Prakash¹  Peter Pugh²  Gareth Corbett³  David de Monteverde-Robb⁴  Teik Choon See⁵  Jurgen Herre⁶  Rhodri Saunders⁷  Rafael Torrejon Torres⁷  Catherine Leonard⁸ 

[1] Department of Anaesthesia, Cambridge University Hospital National Health Service Trust, Cambridge, United Kingdom;Department of Cardiology, Cambridge University Hospital National Health Service Trust, Cambridge, United Kingdom;Department of Gastroenterology, Cambridge University Hospital National Health Service Trust, Cambridge, United Kingdom;Department of Pharmacy, Cambridge University Hospital National Health Service Trust, Cambridge, United Kingdom;Department of Radiology, Cambridge University Hospital National Health Service Trust, Cambridge, United Kingdom;Department of Respiratory Medicine, Cambridge University Hospital National Health Service Trust, Cambridge, United Kingdom;Health Economics, Coreva Scientific, Koenigswinter, Germany;Health Economics, Medtronic UK Ltd., Watford, United Kingdom;

关键词: safe sedation practice;    monitoring;    respiratory compromise;    endoscopy;    bronchoscopy;    patient safety;   

DOI  :  10.3389/fmed.2022.867536

来源: DOAJ

【 摘 要 】

BackgroundCapnography has been associated with a reduced incidence of events related to respiratory compromise during procedural sedation.MethodsA prospective service evaluation was conducted at a large United Kingdom (UK) teaching hospital to assess the impact of capnography on patient safety within four speciality services: bronchoscopy, endoscopy, interventional cardiology, and interventional radiology. Events were defined as provided by the World Society of Intravenous Anaesthesia. One thousand four hundred one patients were enrolled in the evaluation, with 666 patients before and 735 after implementation of capnography. Data was entered as a convenience sample on site in an offline data-collection tool. Results were assessed for the relative reduction in the incidence and resulting adjusted odds ratio for the combined incidence of oxygen desaturation (75–90% for <60s), severe oxygen desaturation (<75% at any time) or prolonged oxygen desaturation (<90% for >60s), bradycardia (>25% from baseline) and tachycardia (>25% from baseline). The adjusted odds ratio was controlled for both procedure and patient characteristics.ResultsAfter implementation of capnography, a significant reduction (43.2%, p≤0.05) in adverse events was observed: 147 adverse events occurred during 666 procedures without capnography compared with 93 adverse events that occurred during 735 procedures with capnography. The adjusted odds ratio for the occurrence of the target adverse events was 0.57 (95% CI: 0.42–0.77). Multivariable linear regression indicated that capnography was a significant predictor (p 0.001) of reduced adverse events.ConclusionThese results suggest improved patient safety following capnography implementation.

【 授权许可】

Unknown