ArticleCritical care medicine2019
Compared Efficacy of Four Preoxygenation Methods for Intubation in the ICU: Retrospective Analysis of McGrath Mac Videolaryngoscope Versus Macintosh Laryngoscope (MACMAN) Trial Data.
Article in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Effectiveness of noninvasive ventilation for preoxygenation in emergency intubation: a systematic review and meta-analysis.Critical care science · 2026Pooled it
- Non-Invasive Positive Pressure Ventilation for Pre-Oxygenation of Critically Ill Patients Before Intubation.Journal of clinical medicine · 2025Review
- Tracheal Intubation in Emergency Departments in China: A National Cross-Sectional Survey.Frontiers in medicine · 2022Article
- Comparison of four channelled videolaryngoscopes to Macintosh laryngoscope for simulated intubation of critically ill patients: the randomized MACMAN2 trial.Annals of intensive care · 2021Article
- Oxygen reserve index for non-invasive early hypoxemia detection during endotracheal intubation in intensive care: the prospective observational NESOI study.Annals of intensive care · 2021Article
- Emergency Department Management of Severe Hypoxemic Respiratory Failure in Adults With COVID-19.The Journal of emergency medicine · 2021Review
- Nationwide survey on training and device utilization during tracheal intubation in French intensive care units.Annals of intensive care · 2020Article
- Preoxygenation for tracheal intubation in critically ill patients: one technique does not fit all.Journal of thoracic disease · 2019Article
- Nasal high-flow preoxygenation for endotracheal intubation in the critically ill patient? Maybe.Intensive care medicine · 2019Article
- Nasal high-flow preoxygenation for endotracheal intubation in the critically ill patient? Pro.Intensive care medicine · 2019Article
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Authors and funding
18 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSevere hypoxemia is the most common serious adverse event during endotracheal intubation. Preoxygenation is performed routinely as a preventive measure. The relative efficacy of the various available preoxygenation devices is unclear. Here, our objective was to assess associations between preoxygenation devices and pulse oximetry values during endotracheal intubation.
designPost hoc analysis of data from a multicenter randomized controlled superiority trial (McGrath Mac Videolaryngoscope Versus Macintosh Laryngoscope [MACMAN]) comparing videolaryngoscopy to Macintosh laryngoscopy for endotracheal intubation in critical care.
settingSeven French ICUs. PATIENTS: Three-hundred nineteen of the 371 critically ill adults requiring endotracheal intubation who were included in the MACMAN trial.
interventionsNone. MEASUREMENTS AND MAIN
resultsMinimal pulse oximetry value during endotracheal intubation was the primary endpoint. We also sought risk factors for pulse oximetry below 90%. Of 319 patients, 157 (49%) had bag-valve-mask, 71 (22%) noninvasive ventilation, 71 (22%) non-rebreathing mask, and 20 (7%) high-flow nasal oxygen for preoxygenation. Factors independently associated with minimal pulse oximetry value were the Simplified Acute Physiology Score II severity score (p = 0.03), baseline pulse oximetry (p < 0.001), baseline PaO2/FIO2 ratio (p = 0.02), and number of laryngoscopies (p = 0.001). The only independent predictors of pulse oximetry less than 90% were baseline pulse oximetry (odds ratio, 0.71; 95% CI, 0.64-0.79; p < 0.001) and preoxygenation device: with bag-valve-mask as the reference, odds ratios were 1.10 (95% CI, 0.25-4.92) with non-rebreathing mask, 0.10 (95% CI, 0.01-0.80) with noninvasive ventilation, and 5.75 (95% CI, 1.15-28.75) with high-flow nasal oxygen.
conclusionsOur data suggest that the main determinants of hypoxemia during endotracheal intubation may be related to critical illness severity and to preexisting hypoxemia. The differences across preoxygenation methods suggest that noninvasive ventilation may deserve preference in patients with marked hypoxemia before endotracheal intubation. Ongoing studies will provide further clarification about the optimal preoxygenation method for endotracheal intubation in critically ill patients.
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