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A Multicenter Randomized Trial of a Checklist for Endotracheal Intubation of Critically Ill Adults
- Publication Year :
- 2017
- Publisher :
- American College of Chest Physicians, 2017.
-
Abstract
- Background Hypoxemia and hypotension are common complications during endotracheal intubation of critically ill adults. Verbal performance of a written, preintubation checklist may prevent these complications. We compared a written, verbally performed, preintubation checklist with usual care regarding lowest arterial oxygen saturation or lowest systolic BP experienced by critically ill adults undergoing endotracheal intubation. Methods A multicenter trial in which 262 adults undergoing endotracheal intubation were randomized to a written, verbally performed, preintubation checklist (checklist) or no preintubation checklist (usual care). The coprimary outcomes were lowest arterial oxygen saturation and lowest systolic BP between the time of procedural medication administration and 2 min after endotracheal intubation. Results The median lowest arterial oxygen saturation was 92% (interquartile range [IQR], 79-98) in the checklist group vs 93% (IQR, 84-100) with usual care ( P = .34). The median lowest systolic BP was 112 mm Hg (IQR, 94-133) in the checklist group vs 108 mm Hg (IQR, 90-132) in the usual care group ( P = .61). There was no difference between the checklist and usual care in procedure duration (120 vs 118 s; P = .49), number of laryngoscopy attempts (one vs one attempt; P = .42), or severe life-threatening procedural complications (40.8% vs 32.6%; P = .20). Conclusions The verbal performance of a written, preprocedure checklist does not increase the lowest arterial oxygen saturation or lowest systolic BP during endotracheal intubation of critically ill adults compared with usual care. Trial Registry ClinicalTrials.gov; No.: NCT02497729; URL: www.clinicaltrials.gov.
- Subjects :
- Pulmonary and Respiratory Medicine
Critical Care
medicine.medical_treatment
Critical Illness
Laryngoscopy
Critical Care and Intensive Care Medicine
Hypoxemia
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Interquartile range
law
Multicenter trial
medicine
Intubation, Intratracheal
Intubation
Humans
medicine.diagnostic_test
business.industry
030208 emergency & critical care medicine
Baths
Checklist
030228 respiratory system
Anesthesia
Airway management
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....ec7d3c7ecd376cd3c9ab64e5915457b4