Did intubation procedures for critically ill patients without SARS-CoV-2 infection change during the pandemic?...

To determine the changes in intubation procedures of critically ill patients without SARS-CoV-2 infection induced during the COVID-19 pandemic.

Secondary Analysis of the INTUPROS Prospective Multicenter Observational Study on Intubation in Intensive Care Units (ICUs).

43 Spanish ICUs between April 2019 and October 2020.

1515 Non-COVID-19 patients intubated before and during the pandemic.

None.

Intubation procedures and medication, first-pass success rate, complications, and mortality.

1199 patients intubated before the pandemic and 316 during the pandemic were analyzed. During the pandemic, there were fewer days until intubation (OR 0.95 95% CI [0.92-0.98]), reduced resuscitation bag (OR 0.43 95% CI [0.29-0.63]) and non-invasive ventilation oxygenation (OR 0.51 95% CI [0.34-0.76]), reduced use of capnography (OR 0.55 95% CI [0.33-0.92]) and fentanyl (OR 0.47 95% CI [0.34-0.63]). On the other hand, there was an increase in oxygenation with non-HFNC devices (OR 2.21 95% CI [1.23-3.96]), in use of videolaryngoscopy on the first-pass (OR 2.74 95% CI [1.76-4.24]), and greater use of midazolam (OR 1.95 95% CI [1.39-2.72]), etomidate (OR 1.78 95% CI [1.28-2.47]) and succinylcholine (OR 2.55 95% CI [1.82-3.58]). The first-pass success was higher (68.5% vs. 74.7%; P=.033). There were no pre-post differences in major complications (34.7% vs. 34.8%; P=.970) and in-hospital mortality (42.7% vs. 38.6%; P=.137).

The COVID-19 pandemic modified intubation procedures in non-COVID-19 patients, changing the oxygenation strategy, the medication and the use of videolaryngoscopy, with no impact on complications or mortality.