Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients/Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients/Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients-Reply

• Published in: JAMA : the journal of the American Medical Association 2021-08, Vol.326 (6), p.568
• Main Authors: Bloomstone, Joshua A, Eckhardt, William F, Masuda, Takahiro, Nosaka, Nobuyuki, Nagashima, Michio, Laffey, John, Bellani, Giacomo, Russotto, Vincenzo
• Format: Article
• Language: English
• Subjects: Anesthesia; Intubation; Morbidity; Physicians; Strategic management
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.2021.8529

We have several comments about the recent study describing intubation practices and peri-intubation events in critically ill patients from 29 countries. First, previous studies concerning peri-intubation morbidity in critically ill patients have demonstrated that early identification and strategic management by skilled and experienced clinicians can save lives. Although it is reassuring that fewer adverse events were reported in this study when patients underwent intubation by attending physicians, the lesson learned from the UK's National Emergency Laparotomy audit and from the Emergency Anesthesia Services Guidelines that followed is that critically ill patients requiring intubation deserve attending-level care. Sadly, this lesson has not been widely operationalized, as resident physicians were responsible for intubating 52% of the patients in this study. More information regarding resident experience level, their intubation skills, and the immediate availability of senior level backup would be of interest.