Enhancing Intubation Techniques in the Intensive Care Unit: a Comprehensive Review of Contemporary Knowledge and Innovative Devices for Optimal Patient Outcome and Procedural Efficacy in Critical Care Settings.
Year: 2025
Type: article
Abstract: Tracheal intubation in the critically ill is associated with serious complications, mainly cardiovascular collapse and severe hypoxemia. In this narrative review, we present an update of interventions aiming to decrease these complications. MACOCHA is a simple score that helps to identify patients at risk of difcult intubation in the intensive care unit (ICU). Preoxygenation combining the use of inspiratory support and positive end expiratory pressure should remain the standard method for preoxygenation of hypoxemic patients. Apneic oxygenation using high-ow nasal oxygen may be supplemented, to prevent further hypoxemia during tracheal intubation. Face mask ventilation after rapid sequence induction may also be used to prevent hypoxemia, in selected patients without high-risk of aspiration.Hemodynamic optimization and management are essential before, during and after the intubation procedure. All these elements can be integrated in a bundle. An airway management algorithm should be adopted in each ICU and adapted to the needs, situation and expertise of each operator. Videolaryngoscopes should be used by experienced operators.
Institutions: Fortis Hospital, Fortis Hospital
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414711150
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