• L Cattin, F Ferrari, S Mongodi, E Pariani, G Bettini, F Daverio, K Donadello, E Polati, F Mojoli, V Danzi, and S De Rosa.
• Department of Anesthesia and Intensive Care Unit, St. Bortolo Hospital, Vicenza, Italy.
• Med Intensiva. 2023 Mar 1; 47 (3): 131139131-139.

ObjectiveFew studies have reported the implications and adverse events of performing endotracheal intubation for critically ill COVID-19 patients admitted to intensive care units. The aim of the present study was to determine the adverse events related to tracheal intubation in COVID-19 patients, defined as the onset of hemodynamic instability, severe hypoxemia, and cardiac arrest.SettingTertiary care medical hospitals, dual-centre study performed in Northern Italy from November 2020 to May 2021.PatientsAdult patients with positive SARS-CoV-2 PCR test, admitted for respiratory failure and need of advanced invasive airways management.InterventionsEndotracheal Intubation Adverse Events.Main Variables Of InterestsThe primary endpoint was to determine the occurrence of at least 1 of the following events within 30 minutes from the start of the intubation procedure and to describe the types of major adverse peri-intubation events: severe hypoxemia defined as an oxygen saturation as measured by pulse-oximetry <80%; hemodynamic instability defined as a SBP 65 mmHg recoded at least once or SBP < 90 mmHg for 30 minutes, a new requirement or increase of vasopressors, fluid bolus >15 mL/kg to maintain the target blood pressure; cardiac arrest.ResultsAmong 142 patients, 73.94% experienced at least one major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 65.49% of all patients undergoing emergency intubation, followed by severe hypoxemia (43.54%). 2.82% of the patients had a cardiac arrest.ConclusionIn this study of intubation practices in critically ill patients with COVID-19, major adverse peri-intubation events were frequent.Clinical Trial Registrationwww.clinicaltrials.gov identifier: NCT04909476.© 2022 Published by Elsevier España, S.L.U.

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