• Ann Emerg Med · Oct 2024

    Association Between Neuromuscular Blocking Agents and Outcomes of Emergency Tracheal Intubation: A Secondary Analysis of Randomized Trials.

    • Stephanie C DeMasi, Wesley H Self, Neil R Aggarawal, Michael D April, Luke Andrea, Christopher R Barnes, Jason Brainard, Veronika Blinder, Alon Dagan, Brian Driver, Kevin C Doerschug, Ivor Douglas, Matthew Exline, Daniel G Fein, John P Gaillard, Sheetal Gandotra, Kevin W Gibbs, Adit A Ginde, Stephen J Halliday, Jin H Han, Taylor Herbert, Kevin High, Christopher G Hughes, Akram Khan, Andrew J Latimer, Amelia W Maiga, Steven H Mitchell, Amelia L Muhs, Amira Mohamed, Ari Moskowitz, David B Page, Jessica A Palakshappa, Matthew E Prekker, Edward T Qian, Dan Resnick-Ault, Todd W Rice, Derek W Russel, Steven G Schauer, Kevin P Seitz, Nathan I Shapiro, Lane M Smith, Peter Sottile, Susan Stempek, Stacy A Trent, Derek J Vonderhaar, James E Walker, Li Wang, Micah R Whitson, Jonathan D Casey, Matthew W Semler, and Pragmatic Critical Care Research Group.
    • Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN. Electronic address: stephanie.demasi@vumc.org.
    • Ann Emerg Med. 2024 Oct 8.

    Study ObjectiveTo examine the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt and severe complications during tracheal intubation of critically ill adults in an emergency department (ED) or ICU.MethodsWe performed a secondary analysis of data from 2 multicenter randomized trials in critically ill adults undergoing tracheal intubation in an ED or ICU. Using a generalized linear mixed-effects model with prespecified baseline covariates, we examined the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt (primary outcome) and severe complications during tracheal intubation (secondary outcome).ResultsAmong the 2,440 patients in the trial data sets, 2,339 (95.9%) were included in the current analysis; 475 patients (20.3%) received succinylcholine and 1,864 patients (79.7%) received rocuronium. Successful intubation on the first attempt occurred in 375 patients (78.9%) who received succinylcholine and 1,510 patients (81.0%) who received rocuronium (an adjusted odds ratio of 0.87; 95% CI 0.65 to 1.15). Severe complications occurred in 67 patients (14.1%) who received succinylcholine and 456 patients (24.5%) who received rocuronium (adjusted odds ratio, 0.88; 95% CI 0.62 to 1.26).ConclusionAmong critically ill adults undergoing tracheal intubation, the incidences of successful intubation on the first attempt and severe complications were not significantly different between patients who received succinylcholine and patients who received rocuronium.Copyright © 2024 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…