Incidentes críticos em anestesia no Uruguai - dez anos após: estudo comparativo (1990-2000)

摘要

BACKGROUND AND OBJECTIVES: A survey of Critical Incidents (CI) in Anesthesia is described. Year 2000 results are compared to those obtained in 1990 in search for CI pattern changes throughout this decade. METHODS: Two different forms were used: the first, F1, was a list of predetermined CI to determine the relative frequency of each incident. The second, F2, requested the description of a specific incident chosen by the respondent. RESULTS: In F1 forms, 9482 CI were recorded and the 13 most frequent CI accounted for 50% of events. Results were very similar to those found in 1990, since among the most frequent, 9 CI were repeated in both surveys. First and second most common incidents were also repeated: difficult intubation and arrhythmias. In form F2, 20% of CI had fatal consequences. Five CI accounted for 54% of deaths were due to 5 CI: unexpected cardiac arrest, pulmonary thromboembolism, acute myocardial infarction, vomiting aspiration and hypovolemic shock. Respiratory incidents accounted for 46% of CI, and 24% were due to hemodynamic causes. It is to be noted a significant CI increase during recovery and in the immediate postoperative period. Patients? clinical observation accounted for 63% CI detection. A substantial increase in unpredictable events has been identified. CONCLUSIONS: CI diversity was maintained with decreased respiratory events, although these are still the most frequent. There is a sharp decrease in severe hypoxia accidents related to esophageal intubation and nitrous oxide as single gas. Hemodynamic incidents severity was maintained.