Difficult intubation in the ICU

Authors

  • Clément MONET 1. Service d'Anesthésie et de Réanimation, CHU de Montpellier, Hôpital St-Eloi, Université de Montpellier, Montpellier, CEDEX 5, France. 2. PhyMedExp, Université de Montpellier, INSERM U1046, CNRS UMR, 9214, Montpellier, France.
  • Mathieu CAPDEVILA 1. Service d'Anesthésie et de Réanimation, CHU de Montpellier, Hôpital St-Eloi, Université de Montpellier, Montpellier, CEDEX 5, France. 2. PhyMedExp, Université de Montpellier, INSERM U1046, CNRS UMR, 9214, Montpellier, France.
  • Ines LAKBAR Service d'Anesthésie et de Réanimation, CHU de Montpellier, Hôpital St-Eloi, Université de Montpellier, Montpellier, CEDEX 5, France.
  • Ambre CUNY Service d'Anesthésie et de Réanimation, CHU de Montpellier, Hôpital St-Eloi, Université de Montpellier, Montpellier, CEDEX 5, France.
  • Chloé RAIMBERT Service d'Anesthésie et de Réanimation, CHU de Montpellier, Hôpital St-Eloi, Université de Montpellier, Montpellier, CEDEX 5, France.
  • Chloé BRIANE Department of Anesthesia and Intensive Care unit, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, Montpellier, CEDEX 5, France.
  • Samir JABER 1. Service d'Anesthésie et de Réanimation, CHU de Montpellier, Hôpital St-Eloi, Université de Montpellier, Montpellier, CEDEX 5, France. 2. PhyMedExp, Université de Montpellier, INSERM U1046, CNRS UMR, 9214, Montpellier, France.
  • Audrey DE JONG 1. Service d'Anesthésie et de Réanimation, CHU de Montpellier, Hôpital St-Eloi, Université de Montpellier, Montpellier, CEDEX 5, France. 2. PhyMedExp, Université de Montpellier, INSERM U1046, CNRS UMR, 9214, Montpellier, France.

DOI:

https://doi.org/10.37051/mir-34-002095

Keywords:

ICU, Intubation, Videolaryngoscope, Laryngoscope

Abstract

Difficult and complicated intubation are two different concepts that tend to be confused. Tracheal intubation in the intensive care unit is difficult in 8 to 20% of cases and is accompanied by a severe complication in 38 to 45% of cases. The systematic search for risk factors for difficult intubation and complications is crucial. The MACOCHA score helps identify patients at risk for difficult intubation. Transnasal endoscopy or pre-induction videolaryngoscopy are additional tools to assess this risk. To prevent difficult intubation, the use of a protocol is absolutely essential. This protocol should cover all important points of pre-induction preparation and include a strategy for anticipated and unanticipated difficult intubation. In the event of unanticipated difficult intubation, the issue will be whether ventilation is possible or not, which will be at the heart of the airway management strategy.

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Published

2025-02-24

How to Cite

MONET, C., CAPDEVILA, M., LAKBAR, I., CUNY, A., RAIMBERT, C., BRIANE, C., JABER, S., & DE JONG, A. (2025). Difficult intubation in the ICU. Médecine Intensive Réanimation, 34(1). https://doi.org/10.37051/mir-34-002095

Issue

Vol. 34 No. 1 (2025)

Section

Update

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