Observational studyCritical care (London, England)2025
Peri-intubation complications in critically ill obese patients: a secondary analysis of the international INTUBE cohort.
Observational study 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 NCT03616054 (INternational Observational Study To Understand the Impact and BEst Practices of Airway Management in Critically Ill Patients), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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.
INternational Observational Study To Understand the Impact and BEst Practices of Airway Management in Critically Ill Patients
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of video laryngoscopy versus direct laryngoscopy for critically Ill adults undergoing tracheal intubation: a trial sequential analysis and meta-analysis.BMC anesthesiology · 2026Pooled it
- Article
- Personalizing Peri-Intubation Oxygenation in Patients at Risk of Acute Hypoxemic Respiratory Failure: A Phenotype-Driven Narrative Review of High-Flow Nasal Oxygen and Non-Invasive Ventilation.Journal of personalized medicine · 2026Review
- Airway management in critically ill patients with obesity.Intensive care medicine · 2026Review
- Mechanical ventilation for ICU patient with obesity: current best practices and future directions.Intensive care medicine · 2026Review
- Awake Flexible Scope Intubation in Critically Ill Patients With Physiologically Difficult Airways: A Prospective, Observational Case Series.Critical care explorations · 2026Observational
- The hemodynamics of tracheal intubation in critically ill patients: a narrative review.Journal of intensive care · 2026Review
- Ten tips for a safe approach in airway management.Journal of anesthesia, analgesia and critical care · 2026Review
- Preoxygenation When Standard Approaches Fail: Phenotype-Based Strategies for High-Risk Emergent Intubations.Journal of clinical medicine · 2026Review
- The effect of postoperative weight loss on difficult intubation in bariatric surgery patients: a prospective observational study.Journal of robotic surgery · 2025Article
- Correction: Peri‑intubation complications in critically ill obese patients: a secondary analysis of the international INTUBE cohort.Critical care (London, England) · 2025Article
- Confused with confounders? Understanding the role of directed acyclic graphs in observational research.Critical care (London, England) · 2025Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
22 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAirway management in critically ill obese patients is potentially associated with a higher risk of adverse events due to a constellation of physiological and anatomical challenges. Data from international prospective studies on peri-intubation adverse events in obese critically ill patients are lacking.
methodsINTUBE (International Observational Study to Understand the Impact and Best Practices of Airway Management In Critically Ill Patients) was an international multicentre prospective cohort study enrolling critically ill adult patients undergoing in-hospital tracheal intubation in 197 sites from 29 countries worldwide from October 1, 2018, to July 31, 2019. This secondary analysis compares airway management practices and outcomes between obese (body mass index-BMI
resultsA total of 2946 patients met inclusion criteria for this secondary analysis, 639 (21.7%) obese and 2307 (78.3%) non-obese. Severe peri-intubation hypoxemia was more frequently reported in obese compared to non-obese patients (12.1% vs 8.6% respectively, p = 0.01). Variables independently associated with a higher risk of peri-intubation hypoxemia were baseline SpO
conclusionsCompared to non-obese patients, obese critically ill exhibit a higher incidence of peri-intubation severe hypoxemia. In this population, worse baseline oxygenation and first-pass intubation failure significantly increase the risk of peri-intubation severe hypoxemia. As obesity is linked to a higher likelihood of first-pass intubation failure, likely driven by more challenging airway features, in this high-risk population first attempt should be performed by an expert operator to minimize peri-intubation complications.
trial registrationClinicaltrials.gov NCT03616054 . Registered 3 August 2018.
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