Factors Associated with Desaturation in Pediatric Intubations

In a prior study of pediatric rapid sequence intubation, oxyhemoglobin desaturation (SpO₂ <90%) occurred in 33% of 144 children (half younger than 24 months) who underwent 221 intubations at a high-volume, academic pediatric emergency department during a 1-year period (NEJM JW Emerg Med Nov 2012 and Ann Emerg Med 2012; 60:251). Now, in a planned secondary analysis, investigators reviewed videos to identify variables associated with desaturation.

One third of patients had ≥1 episode of desaturation. Desaturation was more common in patients younger versus older than 24 months (59% vs. 10%). The median duration of attempts was 35 seconds; 13 attempts (6%) lasted longer than 90 seconds. The probability of successful endotracheal tube placement d…