AeroComp

Prevalence of airway complications and association with aerosol precautions – a prospective multicentre service evaluation

PLAN - Pan-London Perioperative Audit and Research Network

Chief Investigator: Dr Kariem El-Boghdadly

AeroComp was a service evaluation exploring the incidence of airway complications amongst patients undergoing general anaesthesia for surgical procedures within NHS Trusts. All adult patients undergoing any surgical procedure (with the exception of obstetric procedures) with the primary method of anaesthesia planned to be general anaesthesia were eligible for enrolment.

The study duration was 5 days of data collection in November and December 2021.

Primary objective

Identify current rate of airway complications (defined as a composite of multiple individual components) in patients undergoing general anaesthesia for elective and emergency procedures.

Secondary objectives

Risk of the primary outcome stratified by each individual component of the aerosol precaution bundle
Individual complications that comprise the primary objective (airway trauma, aspiration, desaturation, difficult intubation, difficult ventilation, second intubator required, laryngospasm, failed intubation, emergency front-of-neck airway, oesophageal intubation).
Association between risk of airway complications and patient COVID-19 status.

You can find more information here.

Summary of results

Data from 5905 patients from 70 hospital sites were included.
Airway complications occurred in 10.0% of patients undergoing general anaesthesia during the study period.
Use of an FFP2 or FFP3 respirator by the airway practitioner was associated with an increased risk of airway complications, mainly related to difficult facemask ventilation and oxygen desaturation on pulse oximetry.
Use of goggles, powered air-purifying respirators, long-sleeved gowns, double gloves and videolaryngoscopy was not associated with a change in airway complication risk.
Most aerosol precautions used during the COVID-19 pandemic were not associated with increased airway complications, apart from FFP2/FFP3 respirator use.

Publication

Potter T, Cronin JN, Kua J, Nurmi E, Wong DJ, Ahmad I, Cook TM, El‐Boghdadly K, Abberton T, Abdelaziz A, Addy M, Aduse‐Poku M, Afifi M, Afzal A, Ahmad A, Ahmad H, Ainsworth J, Alexander R, Ali Y, Allen C, Aly H, Amer S, Anderson C, Andorka M, Applegate R, Armstrong M, Ashiru G, Ashton L, Aspinall M, Aulakh A, Avery B, Aziz R, Azize M, Babits A, Bailes J, Baker C, Baker‐Beal L, Bang JH, Barker O, Barnes J, Barrett V, Bartlett A, Baxter B, Bayliss E, Beattie R, Bedwell T, Begbey A, Bennett A, Berg J, Zilkha J. Aerosol precautions and airway complications: a national prospective multicentre cohort study. Anaesthesia [Internet]. 2022 Sep 7 [cited 2026 May 21]. Available from: https://doi.org/10.1111/anae.15851

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