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Comparison of Acute Airway/Respiratory Complications and Intervention Requirements in Extubations Performed During On-Hours Versus Off-Hours

NCT07752173

RecruitingN/A

Sponsor: Kocaeli City Hospital

Conditions: Extubation Failures, Extubation, Airway Complication of Anaesthesia

Interventions: Extubation, Survey/Questionnaire Administration

Countries: Turkey (Türkiye)

Perioperative airway/respiratory complications are a major driver of morbidity and mortality. While UK audits NAP4 and NAP7 extensively examined major critical events (e.g., cardiac arrest), prospective standardized data on acute, more frequent extubation-phase complications-such as desaturation, laryngospasm, obstruction, bronchospasm, and aspiration-remain scarce. Off-hours procedures carry additional risks related to increased workload, reduced senior supervision, and clinician fatigue, though current evidence is inconclusive and requires further human-factors research using validated tools like the Karolinska Sleepiness Scale (KSS). This prospective cohort study at Kocaeli City Hospital aims to compare the incidence of acute airway/respiratory complications and intervention requirements during extubation and the first 30 minutes post-extubation between on-hours (08:00-16:00) and off-hours (\>16:00). Notably, this will be the first prospective observational study to specifically test NAP7's off-hours risk findings at the extubation stage, with the goal of strengthening patient safety and guiding institutional quality improvement.

Eligibility overview

Sex: ALL

Age: 18 Years to —

Healthy volunteers: No

Study type: OBSERVATIONAL

Eligibility criteria

Inclusion Criteria:

\- Age ≥ 18 years

Undergoing elective or emergency surgery under general anaesthesia with endotracheal intubation

Planned tracheal extubation in the operating theatre or post-anaesthesia care unit (PACU)

Provision of written informed consent (or deferred consent for emergency cases, in accordance with national regulations)

Exclusion Criteria:

* Patients undergoing surgery under regional anaesthesia or sedation without endotracheal intubation

Patients with a tracheostomy in situ

Patients who remain intubated and are transferred to the intensive care unit (ICU) postoperatively

Patients undergoing cardiothoracic surgery involving cardiopulmonary bypass

Emergency airway management performed outside the operating theatre (e.g., ICU, emergency department)

Patients with known or suspected difficult airway requiring awake fibreoptic intubation

Patients who refuse to provide informed consent or withdraw consent during the study

Pregnant patients

Locations (1)

Kocaeli, Izmıt, Turkey (Türkiye)