ArticleCritical care (London, England)2025
Peri-intubation adverse events and clinical outcomes in emergency department patients: the BARCO study.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07574450 (The Taiwan ED Airway Quality Surveillance Registry), which is not on this map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Taiwan ED Airway Quality Surveillance Registry (TEAR): A Prospective Multicenter Observational Study
Who cites it
13 citing papers in PubMed.
- Propofol versus ketamine in rapid sequence intubation in critically ill patients: a prospective, randomized, controlled trial.Intensive care medicine · 2026Trial
- Hemodynamically neutral intubation: management of a physiologically difficult airway.Clinical and experimental emergency medicine · 2026Article
- Prehospital airway and ventilatory management: a collaborative and narrative review.Intensive care medicine · 2026Review
- Curriculum for Airway Skills in Critically Ill Adults: Protocol for a Delphi Evaluation (CASCADE).Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Major Adverse Events Associated With Emergency Endotracheal Intubation in Adult Patients: A Systematic Review.Cureus · 2026Review
- Protocol for a multicentre target trial emulation comparing ketamine and propofol in critically ill adults undergoing emergency intubation.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Review
- The Pharmacology of Physiologically Difficult Airway Management and Impact on Hemodynamics: A Review.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Review
- Ketamine, Etomidate, and Mortality in Emergency Department Intubations.JAMA network open · 2025Observational
- Prophylactic endotracheal intubation prior to emergency endoscopy for acute esophagogastric variceal hemorrhage: a retrospective single center study.BMC gastroenterology · 2025Article
- Correction: Peri-intubation adverse events and clinical outcomes in emergency department patients: the BARCO study.Critical care (London, England) · 2025Article
- A nomogram for predicting intra-operative conversion to endotracheal intubation during non-intubated spontaneous ventilation anesthesia in pulmonary resection: development of a risk prediction model in hypoxic and high-risk patients.Frontiers in medicine · 2025Article
- Emergency department airway management-2026: EMAT clinical policy guideline.Turkish journal of emergency medicineArticle
Corrections and comments
- Erratum issued
Authors and funding
38 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency tracheal intubation in critically ill patients carries a high risk of complications, and practices vary substantially across different settings. Identifying risk factors and understanding how peri-intubation adverse events affect patient outcomes may guide standardization of care and improve survival.
methodsThis prospective cohort study involved 18 emergency departments in Brazil (March 2022-April 2024). We included adults (≥ 18 years) undergoing emergency intubation and excluded patients intubated electively or for cardiac arrest. We defined major peri-intubation adverse events as severe hypoxemia, new hemodynamic instability, or cardiac arrest occurring within 30 min of initiating intubation. The primary outcome was 28-day mortality. Multivariable regression analyses assessed associations between adverse events and mortality, controlling for potential confounders.
resultsAmong 2846 patients, major adverse events occurred in 919 (32.3%) intubations, most frequently new hemodynamic instability (20.0%), followed by severe hypoxemia (12.5%) and cardiac arrest (3.5%). The overall 28-day mortality was 45.1%. Patients experiencing any major adverse event had a significantly higher 28-day mortality (57.6 vs 39.2%; aHR 1.43, 95% CI 1.26-1.62; p < 0.001). Sensitivity analyses confirmed these findings. Successful first-attempt intubation was associated with a reduced likelihood of major adverse events (aOR 0.52; 95% CI 0.41-0.65; p < 0.001).
conclusionOne in three patients undergoing emergency intubation experienced a major peri-intubation adverse event, which was associated with higher 28-day mortality. These results underscore the importance of optimizing intubation strategies to reduce complications and potentially improve patient outcomes in critically ill patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.