Experience in Prehospital Endotracheal Intubation Significantly Influences Mortality of Patients with Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis

@article{Bossers2015ExperienceIP,
  title={Experience in Prehospital Endotracheal Intubation Significantly Influences Mortality of Patients with Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis},
  author={Sebastiaan M Bossers and Lothar A. Schwarte and Stephan Alexander Loer and Jos W. R. Twisk and Christa Boer and Patrick Schober},
  journal={PLoS ONE},
  year={2015},
  volume={10}
}
Background Patients with severe traumatic brain injury (TBI) are at high risk for airway obstruction and hypoxia at the accident scene, and routine prehospital endotracheal intubation has been widely advocated. However, the effects on outcome are unclear. We therefore aim to determine effects of prehospital intubation on mortality and hypothesize that such effects may depend on the emergency medical service providers’ skill and experience in performing this intervention. Methods and Findings… Expand
Prehospital Intubation and Outcome in Traumatic Brain Injury—Assessing Intervention Efficacy in a Modern Trauma Cohort
TLDR
In this modern trauma cohort, prehospital intubation was not independently associated with outcome; however, hypoxia was not a common reason for pre Hospital Intubation, and the procedure did not improve oxygen saturation during transport, while an increasing distance from the hospital increased theintubation frequency. Expand
Expert-Performed Endotracheal Intubation-Related Complications in Trauma Patients: Incidence, Possible Risk Factors, and Outcomes in the Prehospital Setting and Emergency Department
TLDR
The results suggest that airways management in trauma patients carries a very high risk; this finding has implications for the practice of airway management in injured patients. Expand
Prehospital fluid administration in patients with severe traumatic brain injury: A systematic review and meta-analysis.
TLDR
A systematic review and meta-analysis of the effect of different fluid types on outcome in patients with severe TBI did not demonstrate a survival or neurological benefit for one specific fluid type administered in the prehospital setting. Expand
Increased mortality in trauma patients who develop post-intubation hypotension.
TLDR
In the study of trauma patients requiring ETI, development of PIH was common (36.3%) and associated with increased mortality and Intubation practices in critically ill trauma patients is an important patient safety issue that requires further investigation. Expand
Early-Onset Ventilator-Associated Pneumonia in Severe Traumatic Brain Injury: is There a Relationship with Prehospital Airway Management?
TLDR
Prehospital airway management does not have a significant impact on the occurrence of EOVAP in severe TBI patients despite increasing duration of mechanical ventilation, intensive care unit, and hospital stay. Expand
Effect of Pre-Hospital Intubation in Patients with Severe Traumatic Brain Injury on Outcome: A Prospective Cohort Study
TLDR
PHI improves outcome from patients with sTBI and an ISS ≥ 25, and there was a significative interaction with PHI and major trauma. Expand
Physician Prehospital Care in Mexico City: Retrospective Analysis of Endotracheal Intubation in Patients with Severe Head Trauma
TLDR
Patients with severe head injuries cared by prehospital physicians in Mexico City were intubated 51.1% of the time and were more likely to be intubation without the assistance of anesthetics. Expand
The effect of pre-hospital intubation on prognosis in infants, children and adolescents with severe traumatic brain injury
TLDR
This is the first systematic review and meta-analysis about evaluation of the effect of pre-hospital intubation on prognosis in infants, children and adolescents with severe traumatic brain injury. Expand
Increased mortality in trauma patients who develop postintubation hypotension
TLDR
In the study of trauma patients requiring ETI, development of PIH was common (36.3%) and associated with increased mortality and Intubation practices in critically ill trauma patients is an important patient safety issue that requires further investigation. Expand
Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting.
TLDR
Eucapnia at emergency department arrival occurred in 36% of patients and was unaffected by whether ventilation was manually or mechanically controlled, indicating a low incidence of hyperventilation during helicopter transport. Expand
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TLDR
Pre-hospital endotracheal intubation in isolated, moderate to severe TBI patients is associated with a nearly 5-fold increase in mortality and further prospective studies are required to establish guidelines for optimal pre-hospital management of this critically injured patient population. Expand
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Prehospital intubation is associated with a decrease in survival among patients with moderate-to-severe TBI, and more critically injured patients may benefit from pre Hospital Intubation but may be difficult to identify prospectively. Expand
Is Prehospital Endotracheal Intubation Associated with Improved Outcomes In Isolated Severe Head Injury? A Matched Cohort Analysis
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In isolated severe traumatic brain injury, prehospital endotracheal intubation was associated with significantly higher adjusted mortality rate and worsened admission oxygenation. Expand
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TLDR
Suboptimal performance of intubation and subsequent ventilation may offset potential benefits of the procedure, and studies to better define the patient population benefiting from early Intubation will help avoid exposing other patients to a potentially dangerous procedure. Expand
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TLDR
Prehospital intubation is associated with a significant increase in morbidity and mortality in trauma patients with traumatic brain injury who are admitted to the hospital without an acutely lethal injury. Expand
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