Tracheal Intubation
Conditions
Keywords
airway management, critically ill, hemodynamic management, intubation, prospective study, risk factors
Brief summary
In order to examine the current endotracheal intubation practice among critically ill patients, a prospective observational multicenter study of adult critically ill patients was conducted from July 2015 to January 2017 involving 20 ICUs. In this study, the primary aim was to describe, through a prospective observational multicenter study, the current intubation practice of adult critically ill patients undergoing endotracheal intubations with a focus on deriving and validating a prediction model for both immediate airway and hemodynamic complications.
Detailed description
Aim 1: To derive and validate a prediction model for difficult airway (three or more attempts at laryngoscopy to place an endotracheal tube and/or the need for another operator among the critically ill) \[37\]. Aim 2: To derive and validate a prediction model for hemodynamic compromise, i.e., post-intubation hypotension \[defined as a decrease at any point in mean arterial pressure less than 65 mmHg; systolic blood pressure less than 80 mm Hg and/or a reduction in systolic blood pressure of 40% from baseline; or the initiation of, or increase in infusion dosage of, any vasopressor medication (bolus or infusion) during the 30 minute period following intubation\] \[38-39\]. Aim3: To derive and validate a predication model for hypoxemia (decrease in pulse oximetry to oxygen saturation less than 88% during the procedure).
Interventions
None listed
Sponsors
Berkshire Medical Center
Bridgeport Hospital
Detroit Medical Center
Geisinger Clinic
Marshfield Clinic
Memorial Medical Center
Mercy Hospital
University of North Carolina
Johns Hopkins University
University of Kentucky
The Cleveland Clinic
Wake Forest University Health Sciences
Corpus Christi Medical Center
University of Oklahoma
Creighton University
University of Southern California
Essentia Health
Mayo Clinic
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient age ≥ 18 years * Surgical and medical intensive care unit adult patients * Adult patients requiring endotracheal intubation during the time period of study
Exclusion criteria
* Patient age \< 18 years * Endotracheal intubations performed outside the ICU (in the operating room, in and outside the hospital) are excluded
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with Hypoxemia in the 30 minutes following intubation | 30 minutes | — |
| Number of participants with hypotension in the 30 minutes following intubation | 30 minutes | — |
| Number of participants with unanticipated difficult airway | 10 minutes | defined by 3 or more attempts or two operators |
Secondary
| Measure | Time frame |
|---|---|
| Mechanical ventilation free days in-hospital | 28 days or in-hospital |
| Number of participants with disposition to home, nursing home or long term care facility | 30 days or in-hospital |
| Total days of ICU/hospital length of stay | 30 days or in-hospital |
| Number of participants with vital status (dead/alive) | 30 days or in-hospital |
Countries
United States
Outcome results
None listed