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Strategies to improve first attempt success at intubation in critically ill patients

Tracheal intubation in critically ill patients is a high-risk procedure. The risk of complications increases with repeated or prolonged attempts, making expedient first attempt success the goal for airway management in these patients. Patient-related factors often make visualization of the airway and placement of the tracheal tube difficult. Physiologic derangements reduce the patient's tolerance for repeated or prolonged attempts at laryngoscopy and, as a result, hypoxaemia and haemodynamic deterioration are common complications. Operator-related factors such as experience, device selection, and pharmacologic choices affect the odds of a successful intubation on the first attempt. This review will discuss the 'difficult airway' in critically ill patients and highlight recent advances in airway management that have been shown to improve first attempt success and decrease adverse events associated with the intubation of critically ill patients.

Identiferoai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/622528
Date09 1900
CreatorsNatt, B. S., Malo, J., Hypes, C. D., Sakles, J. C., Mosier, J. M.
ContributorsDivision of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of Arizona College of Medicine, Department of Emergency Medicine, University of Arizona College of Medicine
PublisherOXFORD UNIV PRESS
Source SetsUniversity of Arizona
LanguageEnglish
Detected LanguageEnglish
TypeArticle
Rights© The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved.
Relationhttps://academic.oup.com/bja/article-lookup/doi/10.1093/bja/aew061

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