• Micah T Long, Bryan M Krause, Audrey de Jong, John T Dollerschell, J Michael Brewer, Jonathan D Casey, John P Gaillard, Sheetal Gandotra, Shekhar A Ghamande, Kevin W Gibbs, Adit A Ginde, Christopher G Hughes, David R Janz, Akram Khan, Andrew Latimer, Steven Mitchell, David B Page, Derek W Russell, Wesley H Self, Matthew W Semler, Susan Stempek, Stacy Trent, Derek J Vonderhaar, Jason R West, Stephen J Halliday, and Pragmatic Critical Care Research Group (PCCRG).
• Departments of Anesthesiology, Internal Medicine & Emergency Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI.
• Crit. Care Med. 2025 Jan 1; 53 (1): e65e73e65-e73.

ObjectivesDiabetes mellitus has been associated with greater difficulty of tracheal intubation in the operating room. This relationship has not been examined for tracheal intubation of critically ill adults. We examined whether diabetes mellitus was independently associated with the time from induction of anesthesia to intubation of the trachea among critically ill adults.DesignA secondary analysis of data from five randomized trials completed by the Pragmatic Critical Care Research Group (PCCRG).SettingEmergency departments (EDs) or ICUs at 11 centers across the United States that enrolled in randomized trials of a pre-intubation checklist, fluid bolus administration, bag-mask ventilation between induction and laryngoscopy, and intubation using a bougie vs. stylet.PatientsCritically ill adults undergoing tracheal intubation with a laryngoscope in an ED or an ICU.InterventionsNone.Measurements And Main ResultsA total of 2654 patients were included in this analysis, of whom 638 (24.0%) had diabetes mellitus. The mean time from induction of anesthesia to intubation of the trachea was 169 seconds (sd, 137s). Complications occurred during intubation in 1007 patients (37.9%). Diabetes mellitus was not associated with the time from induction of anesthesia to intubation of the trachea (-4.4 s compared with nondiabetes; 95% CI, -17.2 to 8.3 s; p = 0.50). Use of a video vs. direct laryngoscope did not modify the association between diabetes mellitus and the time from induction to intubation (p for interaction = 0.064). Diabetes mellitus was not associated with the probability of successful intubation on the first attempt (85.6% vs. 84.3%; p = 0.46) or complications during intubation (39.8% vs. 37.4%; p = 0.52).ConclusionsAmong 2654 critically ill patients undergoing tracheal intubation in an ED or an ICU, diabetes mellitus was not independently associated with the time from induction to intubation, the probability of successful intubation on the first attempt, or the rate of complications during intubation.Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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