INTUBE study: airway management practice in critically ill patients

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Why study endotracheal intubation?

Endotracheal intubation (ETI) in critically ill patients is a potentially life-threatening procedure, and approximately one-third of ETIs are complicated by severe hypoxia, cardiovascular collapse and cardiac arrest. Critically ill patients are prone to severe complications as the consequence of the underlying acute respiratory failure or haemodynamic instability, reduced oxygen stores and increased oxygen consumption. Moreover, the rate of difficult airway management may be higher in the intensive care unit (ICU) and in the Emergency Department (ED), prolonging the apnoea time and the risk of desaturation.

Despite this high risk, most airway management interventions (starting from the best pre-oxygenation method, as an example) lack high-quality evidence. It is also possible to observe a significant heterogeneity of practice among different geographical areas, possibly due to different operators’ training and background and availability of human and economic resources. 

Study design

We designed a large international multicentre observational study aiming to collect data on morbidity and mortality of intubation-related adverse events in critically ill patients. Secondly, we aim at taking a ‘snapshot’ of current airway management practice around the globe. We will include in our study all adult critically ill patients undergoing in-hospital endotracheal intubation (i.e. in ICU, ED and ward). As intensivists, we will focus on physiological variables underlying the catastrophic evolution that unfortunately we observe in our daily practice when we intubate a patient with ARDS or septic shock. 

The INTUBE study will recruit at least 180 centres worldwide. We ask each centre to collect data from 20 endotracheal intubations, with a maximum recruitment window of 8 weeks for each centre. 


Starting from 1 October 2018, each centre will select its suitable recruitment start date. To date, more than 40 centres (from Europe, America and Asia) applied for participation. INTUBE study is endorsed by the European Society of Intensive Care Medicine. From feedback we have received, we believe this project will have a big success and contribute to increasing the safety and quality of care of our critically ill patients.

Further information and registration

For further information or to register your centre please visit: or send an email to: [email protected]

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Jaber S, Amraoui J, Lefrant J-Y, Arich C, Cohendy R, Landreau L et al. (2006) Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Crit. Care Med, 34: 2355–61.

Russotto V, Cortegiani A, Raineri SM, Gregoretti C, Giarratano A (2017) Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: a systematic review and meta-analysis. J Crit Care, 41: 98–106.

Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S (2011) 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology, 114: 42–8.

Higgs, A, Mc Grath BA, Goddard C et al. (2017) Guidelines for the management of tracheal intubation in critically ill adults. BJA, 120: 323-52. 

Published on : Tue, 19 Jun 2018

airway management, endotracheal intubation, INTUBE study INTUBE study: airway management practice in critically ill patients

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