Article record

脓毒症急诊科插管的特点、实践模式与结局：一项ANZEDAR登记研究

Characteristics, Practice Patterns, and Outcomes of Emergency Department Intubation for Sepsis: An ANZEDAR Registry Study.

临床研究咽喉科IF 1.9Q3

文献信息

PMID	42847126
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Pramod Chandru 查看其他 3 位作者 Hatem Alkhouri；Toby Fogg；Elliot Long
作者单位	Emergency Department, Nepean Hospital, Sydney, New South Wales, Australia. 查看其他 5 条单位信息 Agency for Clinical Innovation, Emergency Care Institute, Sydney, New South Wales, Australia.；Faculty of Medicine, The University of Sydney, New South Wales, Australia.；Emergency Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.；CareFlight, Sydney, New South Wales, Australia.；Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Victoria, Australia.
期刊	Emergency medicine Australasia : EMA
SCI 分区	Q3
IF	1.9
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

目的： 脓毒症是澳大利亚和新西兰危重病的主要原因，超过75%的入院通过急诊科发生。本研究旨在利用一项前瞻性澳大拉西亚登记研究，描述脓毒症插管的人口学特征、诊疗过程、药理学及围插管期不良事件。
方法： 对澳大利亚和新西兰急诊科气道登记（ANZEDAR）前瞻性收集的数据进行回顾性分析，覆盖2010年1月至2026年3月期间的79家医院。识别以脓毒症为主要指征进行的插管。按年龄分层进行儿科亚组分析。统计分析对连续变量采用Mann-Whitney U检验，对分类变量采用卡方检验或Fisher精确检验。
结果： 在11,289例登记插管中，280例（2.5%）因脓毒症实施。确诊年龄小于16岁的儿科患者占280例脓毒症插管中的30例（10.7%）。在所有年龄组中，成人脓毒症患者较非脓毒症患者年龄更大、血流动力学受损更重、分诊至插管时间更长。脓毒症组与非脓毒症组的喉镜视野和首次插管成功率相当。血流动力学并发症发生于27.9%的脓毒症插管中，围插管期心脏骤停为4.6%。脓毒症组较非脓毒症组更少使用波形二氧化碳图（87.5% vs. 94.1%；p < 0.001）。
结论： 急诊科脓毒症插管尽管喉镜视野和首次插管成功率相似，但与高血流动力学并发症发生率相关。婴儿脓毒症中波形二氧化碳图使用率低代表潜在的患者安全问题。这些发现支持采取针对性干预措施。

英文摘要

OBJECTIVE: Sepsis is a leading cause of critical illness in Australia and New Zealand, with over 75% of admissions occurring through emergency departments. This study aimed to characterise the demographics, process of care, pharmacology, and peri-intubation adverse events of sepsis intubations using a prospective Australasian registry.
METHODS: A retrospective analysis of prospectively collected data from the Australian and New Zealand Emergency Department Airway Registry (ANZEDAR) was performed across 79 hospitals between January 2010 and March 2026. Intubations performed for a primary indication of sepsis were identified. A paediatric subgroup analysis was performed stratified by age band. Statistical comparisons used Mann-Whitney U tests for continuous variables and chi-square or Fisher's exact tests for categorical variables.
RESULTS: Of 11,289 registry intubations, 280 (2.5%) were performed for sepsis. Paediatric patients with confirmed age under 16 years comprised 30 of 280 sepsis intubations (10.7%). Adults were older, more haemodynamically compromised, and had longer triage to intubation times than non-sepsis patients across all age groups. Laryngoscopic views and first-pass success were comparable between sepsis and non-sepsis groups. Haemodynamic complications occurred in 27.9% of sepsis intubations and peri-intubation cardiac arrest in 4.6%. Waveform capnography was used less frequently in sepsis versus non-sepsis groups (87.5% vs. 94.1%; p < 0.001).
CONCLUSION: Emergency department sepsis intubation is associated with high rates of haemodynamic complications despite similar laryngoscopic views and first-pass success rates. Low waveform capnography use in infant sepsis represents a potential patient safety concern. These findings support targeted interventions.