Preventing Hypoxemia with Noninvasive Ventilation During Emergency Intubation

In a randomized trial, preoxygenation with NIV significantly and safely lowered the incidence of hypoxemia in critically ill adults.

Critically ill patients who develop hypoxemia during tracheal intubation are more likely to suffer cardiac arrest and death. To examine whether preoxygenation with noninvasive ventilation (NIV) can mitigate this problem, U.S. investigators randomized 1300 critically ill adults who required intubation to NIV (at least 3 minutes before anesthesia induction) or to a simple oxygen mask.

All intubations occurred in the emergency department (27%) or intensive care unit (73%); residents or fellows performed 86% of intubations. Video laryngoscopy was used in >80% of patients (NEJM JW Gen Med Jul 15 2023 and N Engl J Med 2023; 389:418). First attempts were successful in >80% of intubations.

Compared with patients in the oxygen-mask group, those in the…

Reviewing Authors

Raja-Elie E. Abdulnour, MD

Disclosures

Nothing to disclose

Raja-Elie E. Abdulnour, MD

Disclosures

Nothing to disclose

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Preventing Hypoxemia with Noninvasive Ventilation During Emergency Intubation

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Reviewing Authors