A Nationwide, Prospective Study of Tracheal Intubation in Critically Ill Adults in Spain: Management, Associated Complications, and Outcomes*
Authors' conclusion
A major adverse event occurred in up to 40% of the adults intubated in the ICU. Peri-intubation hemodynamic instability but not severe hypoxemia was identified as an independent predictor of death. The use of NMBAs was a protective factor for major adverse events, whereas the use of videolaringoscopy increases the first-pass success rate of intubation. Intubation practices changed during the COVID-19 pandemic.
Study context
- Population
- Critically ill adults undergoing tracheal intubation in 43 Spanish ICUs, 2019–2020
- Participants
- 1,837 adults · 43 ICUs
- Outcome
- Major adverse peri-intubation events
Methodological detailsmulticentre, nationwide, Enrollment period six months per centre, between April 16, 2019 and October 31, 2020
- Multicentre
- Nationwide
- Enrollment period six months per centre, between April 16, 2019 and October 31, 2020
Main finding
As reported in the abstract
Patients with ≥1 major adverse peri-intubation event
40.4 %
Major adverse events registered
973
Hemodynamic instability
26.5%
Severe hypoxemia
20.3%
Observational data: associations, not effects.
Further findings
First-attempt intubation failure: videolaryngoscopy at first attempt (protective factor)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Videolaryngoscopy at first attemptOnly protective factor | 0.43 (0.28–0.66) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
First-attempt intubation success
- Intubation on first attempt
- 70.8%
Practice change during COVID-19 pandemic
- Use of videolaryngoscopy and neuromuscular blocking agents (NMBAs) increased significantly
28-day mortality
- Major peri-intubation event an independent risk factor for 28-day mortality; cardiovascular collapse an independent predictor of death
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →