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

Published

Journal Article

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.

Full Text

Cited Authors

  • Janz, DR; Semler, MW; Joffe, AM; Casey, JD; Lentz, RJ; deBoisblanc, BP; Khan, YA; Santanilla, JI; Bentov, I; Rice, TW; Check-UP Investigators*, ; Pragmatic Critical Care Research Group,

Published Date

  • April 2018

Published In

Volume / Issue

  • 153 / 4

Start / End Page

  • 816 - 824

PubMed ID

  • 28917549

Pubmed Central ID

  • 28917549

Electronic International Standard Serial Number (EISSN)

  • 1931-3543

International Standard Serial Number (ISSN)

  • 0012-3692

Digital Object Identifier (DOI)

  • 10.1016/j.chest.2017.08.1163

Language

  • eng