Intensive Care Med. 2014 May;40(5):727-9. doi: 10.1007/s00134-014-3261-4.
Successful first attempt intubation of the critically ill patient is of extreme importance. While these patients are anatomically and physiologically complicated, making intubation particularly risky, several important steps have recently been shown to improve the chances of a safe first attempt success. Proper evaluation, planning, positioning, preoxygenation, and in select patients the use of a neuromuscular blocking agent have all been shown to be useful for minimizing the difficult intubation and intubation- related complications. Additionally, although there is significant controversy regarding video laryngoscopy, the use of a video laryngoscope as the primary method of intubation has been shown in all cases to be at least as good as, and often more successful than, direct laryngoscopy.
成功地对危重症患者进行首次插管至关重要。尽管这些患者在解剖结构和生理机能上较为复杂，使插管特别具有风险，但最近已经证实，有几个重要步骤可以提高安全进行首次尝试的成功率。适当的评估、计划、定位、预充氧，以及在某些患者中使用神经肌肉阻滞剂，都已被证明有助于最大限度地减少困难插管和与插管相关的并发症。此外，尽管视频喉镜存在很大争议，但在所有情况下，使用视频喉镜作为主要插管方法已被证明至少与直接喉镜一样有效，而且通常更成功。
