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Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
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Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation

Published on: December 5, 2025

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A modified Montpellier protocol for intubating intensive care unit patients is associated with an increase in

Keith A Corl1, Christopher Dado2, Ankita Agarwal2

  • 1The Department of Medicine, Division of Pulmonary Critical Care & Sleep, United States; The Department of Emergency Medicine, Alpert Medical School of Brown University, United States; The Brown University School of Public Health, Providence, RI, United States.

Journal of Critical Care
|November 18, 2017
PubMed
Abstract

Insights

A simplified Montpellier protocol improved intubation success in intensive care units (ICUs). This modified approach increased first-pass intubation rates and decreased related complications for critically ill patients.

Area of Science:

  • Critical Care Medicine
  • Anesthesiology
  • Emergency Medicine

Background:

  • The Montpellier protocol is recognized for reducing intubation-related complications in intensive care units (ICUs).
  • A need existed to evaluate a simplified protocol to enhance its effectiveness and applicability.
  • This study investigated a modified Montpellier protocol to improve patient outcomes during intubation.

Purpose of the Study:

  • To assess if a simplified Montpellier protocol increases first-pass intubation success.
  • To determine if the modified protocol reduces intubation-related complications in the ICU.
  • To evaluate the impact of a streamlined intubation strategy on patient safety.

Main Methods:

  • A prospective pre/post-comparison study was conducted in medical and mixed ICUs.
  • An eight-point modified Montpellier protocol was implemented, including specific pre-oxygenation methods.
  • Data from 275 intubations were analyzed, comparing control and intervention periods.

Main Results:

  • The modified protocol led to a significant 16.2% increase in first-pass intubation success.
  • A significant 12.6% reduction in all intubation-related complications was observed.
  • Patient characteristics and intubation indications remained consistent between groups.

Conclusions:

  • A simplified Montpellier protocol effectively improves first-pass intubation success rates in ICUs.
  • The modified protocol is associated with a significant reduction in intubation-related complications.
  • This streamlined approach enhances patient safety during critical care intubations.
Keywords:
First-pass successIntensive care unitIntubationIntubation complicationsMontpellier protocol

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