• David R Janz, Matthew W Semler, Aaron M Joffe, Jonathan D Casey, Robert J Lentz, Bennett P deBoisblanc, Yasin A Khan, Jairo I Santanilla, Itay Bentov, Todd W Rice, Check-UP Investigators*, and Pragmatic Critical Care Research Group.
• Department of Medicine, Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University School of Medicine New Orleans, New Orleans, LA. Electronic address: djanz@lsuhsc.edu.
• Chest. 2018 Apr 1; 153 (4): 816-824.

BackgroundHypoxemia and hypotension are common complications during endotracheal intubation of critically ill adults. Verbal performance of a written, preintubation checklist may prevent these complications. We compared a written, verbally performed, preintubation checklist with usual care regarding lowest arterial oxygen saturation or lowest systolic BP experienced by critically ill adults undergoing endotracheal intubation.MethodsA multicenter trial in which 262 adults undergoing endotracheal intubation were randomized to a written, verbally performed, preintubation checklist (checklist) or no preintubation checklist (usual care). The coprimary outcomes were lowest arterial oxygen saturation and lowest systolic BP between the time of procedural medication administration and 2 min after endotracheal intubation.ResultsThe median lowest arterial oxygen saturation was 92% (interquartile range [IQR], 79-98) in the checklist group vs 93% (IQR, 84-100) with usual care (P = .34). The median lowest systolic BP was 112 mm Hg (IQR, 94-133) in the checklist group vs 108 mm Hg (IQR, 90-132) in the usual care group (P = .61). There was no difference between the checklist and usual care in procedure duration (120 vs 118 s; P = .49), number of laryngoscopy attempts (one vs one attempt; P = .42), or severe life-threatening procedural complications (40.8% vs 32.6%; P = .20).ConclusionsThe verbal performance of a written, preprocedure checklist does not increase the lowest arterial oxygen saturation or lowest systolic BP during endotracheal intubation of critically ill adults compared with usual care.Trial RegistryClinicalTrials.gov; No.: NCT02497729; URL: www.clinicaltrials.gov.Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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