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Expertise in airway management is a vital skill for any provider caring for critically ill patients. A growing body of literature has identified the stark difference in periprocedural outcomes of elective intubation in the operating room when compared with emergency intubation in the ICU. A number of strategies to reduce the morbidity and mortality associated with airway management in the critically ill have been described. In this review, we provide an updated framework for airway assessment before direct laryngoscopy and video laryngoscopy, and use of newer pharmacologic agents; comment on current concepts in tracheal intubation in the ICU; and address human factors around critical decision-making during ICU airway management. [ABSTRACT FROM AUTHOR]

The article reports on the complications associated with airway management in the intensive care unit in a significant number of patients. Among the problems encountered were difficult intubations, esophageal intubations and pulmonary aspiration. Researchers found that there was a significant correlation between the presence of hypotension at the time of intubation and cardiac arrest.

The author offers his counterargument against the article "Counterpoint: Should an Anesthesiologist Be the Specialist of Choice in Managing the Difficult Airway in the ICU? Not Necessarily," by Kevin Doerschug published in the present issue of the journal "Chest." He explains the difference in complication rates of emergency endotracheal intubations (EEIs) between nonanesthesia and anesthesia providers. He asserts that anesthesiologists are best equipped to handle difficult airway management.