• Journal of critical care · Oct 2018

    Multicenter Study Observational Study

    Safety incidents in airway and mechanical ventilation in Spanish ICUs: The IVeMVA study.

    • Ángela Alonso-Ovies, Nicolás Nin, Maria Cruz Martín, Federico Gordo, Paz Merino, José M Añón, Blanca Obón, Mónica Magret, Isabel Gutiérrez, and IVeMVA study investigators.
    • Department of Intensive Care Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain. Electronic address: a.alonso@salud.madrid.org.
    • J Crit Care. 2018 Oct 1; 47: 238-244.

    PurposeTo assess incidence, related factors and characteristics of safety incidents associated with the whole process of airway management and mechanical ventilation (MV) in Spanish ICUs.Materials And MethodsObservational, prospective, 7 days cross-sectional multicenter study. Airway and MV related incidents were reported using structured questionnaire. Type, characteristics, severity, avoidability and contributing factors of the incidents were assessed.ResultsParticipant ICUs: 104. Inclusion of 1267 patients; 745 (59%) suffered one or more incidents. Incidents reported: 2492 (59% non-harm-events, 41% adverse events). Individual risk of suffering at least one incident: 66.6%. Incidence ratio (median) of incidents: 2 per 100 patient-hours. 73.7% of incidents were related to MV process, 9.5% to tracheostomy, 6.2% to non-invasive MV, 5.4% to weaning/extubation, 4.4% to intubation and 0.8% to prone position. Temporary damage was produced in 12% incidents, while 0.8% was related to permanent injuries, risk to the patient's life or contributed to death. Incidents were considered avoidable in 73.5% of cases. 98% of all incidents had 1 or more contributing factors.ConclusionsMV is a risk process in critical patients. Although most incidents did not harm patients, some caused damage and a few were related to the patient's death or permanent damage. Preventability is high.Copyright © 2018 Elsevier Inc. All rights reserved.

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