Study Comparing Delayed and Rapid Sequence Intubation Methods in Adults Needing a Breathing Tube for Non-Traumatic Reasons

What this Trial Is About

Researchers are comparing two methods of helping adult patients breathe using a tube placed in the airway during emergency care. The study focuses on adults who are breathing on their own but need intubation for medical reasons not related to injury. It aims to evaluate oxygen levels, vital signs, procedure success, blood gas results, complications, and early survival following the intubation procedures. This large, multicenter randomized trial uses unique methods like measuring end-tidal CO2 for tube placement confirmation and assessing intubation difficulty with a specific classification system. The study compares Delayed Sequence Intubation DSI and Rapid Sequence Intubation RSI. In DSI, patients receive ketamine to achieve sedation while preserving breathing, followed by preoxygenation and paralysis with rocuronium before intubation. In RSI, patients are preoxygenated first, then given ketamine and rocuronium sequentially before intubation. Both use direct laryngoscopy, and ventilator settings are standardized. Physiological data are recorded throughout the procedures by designated physicians. Participants will be monitored for oxygen levels, blood pH, carbon dioxide, bicarbonate, base excess, lactate levels, and survival rates at various times before, during, and after intubation. The number of intubation attempts and procedure duration are also tracked. Data collection occurs from hospital admission through 28 days post-procedure, with close monitoring of complications and vital signs to assess safety and outcomes during and after intubation.

Comparison of Peri-intubation Oxygenation Values and Complications in Patients Intubated With the Delayed Versus Rapid Sequence Intubation Protocols