Intensive Care Unit Syndrome, Videolaryngoscopy
Conditions
Brief summary
Tracheal intubation in critical care is a high-risk procedure requiring significant expertise and airway strategy modifications, such as awake intubation with video laryngoscope or flexible endoscope intubation. Furthermore, delayed sequence intubation can be used by experts in certain high-risk subgroups. The investigators hypothesise that awake tracheal intubation is associated with a lower incidence of severe adverse events than standard tracheal intubation in critical care patients.
Detailed description
Intubation records from 2020 to 2022 were acquired to examine all tracheal intubations of critical care patients at a tertiary hospital. Each awake tracheal intubation (awake) case - all of which were performed using a videolaryngoscope with a hyperangulated blade - was propensity matched with two controls (1:2 ratio; standard intubation videolaryngoscopy (VL) and direct laryngoscopy (DL) undergoing general anaesthesia), with similar comorbidities and intubations performed after the induction of anaesthesia (asleep).
Interventions
DEVICEtracheal intubation using videolaryngoscope with a hyperangulated blade or standard intubation videolaryngoscopy (VL) and direct laryngoscopy (DL)
In the awake group tracheal intubation performed by an videolaryngoscope with a hyperangulated blade. In the asleep group the standard intubation were performed by videolaryngoscopy (VL) and direct laryngoscopy (DL)
Sponsors
Johannes Gutenberg University Mainz
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Data for all critical care patients requiring tracheal intubation during the study period
Exclusion criteria
* included incomplete data reports
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hypotension | during intubation procedure (within 30 Minutes) | defined as a mean arterial pressure \< 55 mmHg |
| cardiac arrest | during intubation procedure (within 30 Minutes) | defined as a peri-interventional cardiac arrest |
| desaturation | during intubation procedure (within 30 Minutes) | defined as SpO2 \< 80% after sufficient preoxygenation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cormack and Lehane classification (Class I-IV) | during intubation procedure (< 120 seconds) | glottis visualisation |
| FPS | during intubation procedure (< 120 seconds) | First Pass Intubation success |
| Airway Injury | during intubation procedure (< 120 seconds) | dental injury |
| other adverse events | during intubation procedure (< 120 seconds) | soft tissue injury |
Countries
Germany
Outcome results
None listed