CARDIOPULMONARY RESUSCITATION AND OTHER EMERGENCIES: Edited by Marek A. MirskiEmergent airway management of the critically ill patient: current opinion in critical careSklar, Michael C.a; Detsky, Michael E.a,bAuthor Information aInterdepartmental Division of Critical Care Medicine, University of Toronto bDepartment of Medicine, Mount Sinai Hospital, Sinai Health System, Toronto, Canada Correspondence to Michael E. Detsky, MD, Department of Critical Care, Mount Sinai Hospital, 600 University Avenue, Office 18-232, Toronto, ON, Canada M5G 1X5. E-mail: [email protected] Current Opinion in Critical Care: December 2019 - Volume 25 - Issue 6 - p 597-604 doi: 10.1097/MCC.0000000000000659 Buy Metrics Abstract Purpose of review To describe techniques to facilitate safe intubation in critically ill patients. Recent findings Despite advances in the treatment of critically ill patients, endotracheal intubation remains a high-risk procedure associated with complications that can lead to appreciable morbidity and mortality. In addition to the usual anatomical factors that can predict a difficult intubation, incorporating pathophysiological considerations and crisis resource management may enhance safety and mitigate risk. Enhancing preoxygenation with high-flow oxygen or noninvasive ventilation, the early use of intravenous fluids and/or vasopressors to prevent hypotension and videolaryngoscopy for first pass success are all promising additions to airway management. Facilitating intubation by either sedation with paralysis or allowing patients to continue to breathe spontaneously are reasonable options for airway management. These approaches have potential advantages and disadvantages. Summary Recognizing the unique challenges of endotracheal intubation in critically ill patients is paramount in limiting further deterioration during this high-risk procedure. A safe approach to intubation focuses on recognizing risk factors that predict challenges in achieving an optimal view of the glottis, maintaining optimal oxygenation, and minimizing the risks and benefits of sedation/induction strategies that are meant to facilitate intubation and avoid clinical deterioration. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.