Format

Send to

Choose Destination
Chest. 2018 Apr;153(4):816-824. doi: 10.1016/j.chest.2017.08.1163. Epub 2017 Sep 14.

A Multicenter Randomized Trial of a Checklist for Endotracheal Intubation of Critically Ill Adults.

Author information

1
Department of Medicine, Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University School of Medicine New Orleans, New Orleans, LA. Electronic address: djanz@lsuhsc.edu.
2
Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN.
3
Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA.
4
Department of Medicine, Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University School of Medicine New Orleans, New Orleans, LA.
5
Department of Medicine, Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University School of Medicine New Orleans, New Orleans, LA; Department of Medicine, Section of Emergency Medicine, Louisiana State University School of Medicine New Orleans, New Orleans, LA; Department of Pulmonary and Critical Care Medicine, Ochsner Health System New Orleans, New Orleans, LA.

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.

KEYWORDS:

adult; airway management; checklist; critical care; endotracheal; intubation; ventilation

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center