An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multiple-center study

Samir Jaber, Boris Jung, Philippe Corne, Mustapha Sebbane, Laurent Muller, Gerald Chanques, Daniel Verzilli, Olivier Jonquet, Jean-Jacques Eledjam, Jean-Yves Lefrant
Intensive Care Medicine 2010, 36 (2): 248-55

OBJECTIVE: To determined whether the implementation of an intubation management protocol leads to the reduction of intubation-related complications in the intensive care unit (ICU).

DESIGN: Two-phase, prospective, multicenter controlled study.

SETTING: Three medical-surgical ICUs in two university hospitals.

PATIENTS: Two hundred three consecutive ICU patients required 244 intubations.

INTERVENTIONS: All intubations performed during two consecutive phases (a 6-month quality control phase followed by a 6-month intervention phase based on the implementation of an ICU intubation bundle management protocol) were evaluated. The ten bundle components were: preoxygenation with noninvasive positive pressure ventilation, presence of two operators, rapid sequence induction, cricoid pressure, capnography, protective ventilation, fluid loading, preparation and early administration of sedation and vasopressor use if needed.

MEASUREMENTS AND MAIN RESULTS: The primary end points were the incidence of life-threatening complications occurring within 60 min after intubation (cardiac arrest or death, severe cardiovascular collapse and hypoxemia). Other complications (mild to moderate) were also evaluated. Baseline characteristics, including demographic data and reason for intubation (mainly acute respiratory failure), were similar in the two phases. The intubation procedure in the intervention phase (n = 121) was associated with significant decreases in both life-threatening complications (21 vs. 34%, p = 0.03) and other complications (9 vs. 21%, p = 0.01) compared to the control phase (n = 123).

CONCLUSIONS: The implementation of an intubation management protocol can reduce immediate severe life-threatening complications associated with intubation of ICU patients.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"