Study reveals life-threatening complications for patients on respiratory life support

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Professor John Laffey, who co-authored the study

Some 40% of critically ill patients who undergo tracheal intubation to support their breathing suffer a life-threatening complication, research from NUI Galway has revealed.

The study, published today in JAMA: The Journal of the American Medical Association, involved 2,964 critically ill men and women.

It was carried out across 29 countries from 1 October 2018 to 31 July 2019 to determine the risk of adverse events arising from the invasive procedure.

John Laffey, Professor of Intensive Care Medicine at NUI Galway and Consultant in Anaesthesia and Intensive Care Medicine at University Hospital Galway, co-authored the study.

Professor Laffey said that placing a critically-ill patient on a ventilator is one of the most common forms of life support we can offer someone in intensive care.

“But in order to provide this treatment clinicians have to perform tracheal intubation – an invasive procedure where a tube is inserted via the mouth into the windpipe,” he said.

“A better knowledge and understanding of the complications associated with this procedure is of particular importance as we respond to the impact of Covid-19.

“The pandemic is forcing us medics to do far more of these procedures than usual and understanding the associated complications is the first step to finding ways to avoid them in future, and hopefully reduce the risk to our patients.”

Findings from the INTUBE research study have been presented by Professor Laffey at the Society of Critical Care Conference.

A total of 45.2% of patients experienced at least one life-threatening complication following intubation, while some 42.6% of patients suffered severe cardiovascular instability.

272 patients, 9.3% of those in the study, suffered severe hypoxemia or very low oxygen levels and 93 patients, 3.1% of those in the study, suffered cardiac arrest.

Professor Tim O’Brien, Dean of the College of Medicine, Nursing and Health Sciences at NUI Galway and Consultant Physician with Saolta University Healthcare Group, said that clinical research in intensive care units is challenging but it is critically important to guide clinical practice and is essential to improve survival rates.

“Studies like this have a major impact on clinical practice and of course the relevance of this study is accentuated as a result of Covid,” said Professor O’Brien.