Management of tracheal intubation in the respiratory intensive care unit by pulmonary physicians.
BACKGROUND
Expert management of tracheal intubation has become fundamental to the routine practice of pulmonary physicians who work in respiratory intensive care units (ICUs). In Italy, tracheal intubation is not included as part of the training in respiratory medicine, and pulmonary physicians are usually dissuaded from managing intubations.


METHODS
We prospectively studied the intubation success rate in 46 consecutive respiratory ICU patients who required either emergency or urgent intubation, conducted by 3 intubation-trained pulmonary physicians in our respiratory ICU. Intubation success was defined as successful tracheal intubation without any of 7 pre-defined complications.


RESULTS
There were 17 emergency intubations and 29 urgent intubations. Intubation was successful in 43 of the 46 intubation attempts. Complications occurred in 3 cases: 2 patients needed to be intubated by an anesthesiologist, and 1 patient received fiberoptic intubation.


CONCLUSIONS
Pulmonary physicians trained in tracheal intubation can have a high success rate in performing intubation in the respiratory ICU. Collaborative efforts between anesthesiologists and pulmonary physicians are necessary to optimize the training, skill-retention, and back-up for advanced airway management in the respiratory ICU.
Vianello
Andrea M A
AM
Unità Operativa Fisiopatologia Respiratoria, Azienda Ospedaliera di Padova, Via Giustiniani 3, 35128 Padova, Italy. avianello@qubisoft.it
Arcaro
Giovanna M E
GM
Braccioni
Fausto S
FS
Gallan
Federico
F
Greggio
Chiara M
CM
Marangoni
Anna
A
Ori
Carlo
C
Minuzzo
Michele
M
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods / Q000592:standards*; D008297:Male; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D015272:Pulmonary Medicine; D012124:Respiratory Care Units; D012140:Respiratory Tract Diseases / Q000628:therapy*; D016896:Treatment Outcome; D000078329:Workforce