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* From the Medical-Surgical Intensive Care Unit (Dr. Reynolds), University Health Network and Mount Sinai Hospital, Toronto, ON, Canada; and the Division of Pulmonary and Critical Care Medicine, Allergy, and Clinical Immunology (Dr. Heffner), Medical University of South Carolina, Charleston, SC.
Correspondence to: John Heffner, MD, FCCP, Medical University of South Carolina, 169 Ashley Ave, PO Box 250332, Charleston, SC 29425; e-mail: heffnerj{at}musc.edu
Advances in emergency airway management have allowed intensivists to use intubation techniques that were once the province of anesthesiology and were confined to the operating room. Appropriate rapid-sequence intubation (RSI) with the use of neuromuscular blocking agents, induction drugs, and adjunctive medications in a standardized approach improves clinical outcomes for select patients who require intubation. However, many physicians who work in the ICU have insufficient experience with these techniques to adopt them for routine use. The purpose of this article is to review airway management in the critically ill adult with an emphasis on airway assessment, algorithmic approaches, and RSI.
Key Words: airway management ICU induction agents intensivist intubation neuromuscular blocking agents rapid-sequence intubation respiratory failure
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