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

Frontiers in Medicine

article

Gareth Corbett¹  Peter Pugh²  Jurgen Herre³  Teik Choon See⁴  David de Monteverde-Robb⁵  Rafael Torrejon Torres⁶  Rhodri Saunders⁶  Catherine Leonard⁷  Amit Prakash⁸ 

[1] Department of Gastroenterology, Cambridge University Hospital National Health Service Trust;Department of Cardiology, Cambridge University Hospital National Health Service Trust;Department of Respiratory Medicine, Cambridge University Hospital National Health Service Trust;Department of Radiology, Cambridge University Hospital National Health Service Trust;Department of Pharmacy, Cambridge University Hospital National Health Service Trust;Health Economics;Health Economics, Medtronic UK Ltd.;Department of Anaesthesia, Cambridge University Hospital National Health Service Trust

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

DOI  :  10.3389/fmed.2022.867536

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Capnography has been associated with a reduced incidence of events related to respiratory compromise during procedural sedation. Methods A 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), bradycardia (>25% from baseline) and tachycardia (>25% from baseline). The adjusted odds ratio was controlled for both procedure and patient characteristics. Results After 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. Conclusion These results suggest improved patient safety following capnography implementation.

【 授权许可】

CC BY