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.
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).
Study Type
OBSERVATIONAL
Enrollment
140
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)
Department of Anesthesiology,Prof. C. Werner, Universitätsmedizin of the JG University
Mainz, Rhineland-Palatinate, Germany
Hypotension
defined as a mean arterial pressure \< 55 mmHg
Time frame: during intubation procedure (within 30 Minutes)
cardiac arrest
defined as a peri-interventional cardiac arrest
Time frame: during intubation procedure (within 30 Minutes)
desaturation
defined as SpO2 \< 80% after sufficient preoxygenation
Time frame: during intubation procedure (within 30 Minutes)
Cormack and Lehane classification (Class I-IV)
glottis visualisation
Time frame: during intubation procedure (< 120 seconds)
FPS
First Pass Intubation success
Time frame: during intubation procedure (< 120 seconds)
Airway Injury
dental injury
Time frame: during intubation procedure (< 120 seconds)
other adverse events
soft tissue injury
Time frame: during intubation procedure (< 120 seconds)
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