Endotracheal tube and stylet versus an endotracheal tube alo
Tracheal intubation is one of the most commonly performed procedures in the ICU. A current study suggests that the use of a stylet for tracheal intubation in critically ill adult patients resulted in significantly higher first-attempt intubation success than the use of tracheal tube alone. The study was published in the journal Intensive Care Medicine.

In this multicentre randomized controlled trial, conducted in 32 ICUs, researchers randomly assigned patients to tracheal tube + stylet or tracheal tube alone. The primary outcome was the proportion of patients with first-attempt intubation success. The secondary outcome was the proportion of patients with complications related to tracheal intubation. Serious adverse events, i.e., traumatic injuries related to tracheal intubation, were evaluated.

A total of 999 patients were included in the modified intention-to-treat analysis: 501 to tracheal tube + stylet and 498 to tracheal tube alone.

--First-attempt intubation success occurred in 392 patients in the tracheal tube + stylet group and in 356 in the tracheal tube alone group.

--A total of 194 patients in the tracheal tube + stylet group had complications related to tracheal intubation, as compared with 200 patients in the tracheal tube alone group.

--The incidence of serious adverse events was 4.0% and 3.6%, respectively.

In conclusion, among critically ill adults undergoing tracheal intubation, using a stylet improves first-attempt intubation success.

Source: https://doi.org/10.1007/s00134-021-06417-y
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