Tracheal Intubation in COVID-19 Patients

Study Overview
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Brief Summary
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The Emergency Endotracheal intubation of a patient who is COVID-19 positive is a high-risk procedure and an additional challenge to an intensivist due to barrier enclosures that have been developed to reduce the risk of COVID-19 transmission to healthcare providers during intubation. Although the incidence of difficult airways is commonly higher in critically ill patients, the evidence of severe hypoxemia without sign of respiratory distress could complicate the scenario.This silent hypoxia often leads to a delayed recognition of the severity of respiratory failure and to a late intubation which is often characterized by a high risk of complications related to the actual airways' management, hemodynamic and cardiac. It has been shown that non-survivors had worse blood gas analyzes than survivors, both before and after intubation. Few studies have reported the implications and adverse events of performing endotracheal intubation for critically ill COVID-19 patients admitted to intensive care units (ICUs).

Official Title
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Airways Management in COVID-19 Related Respiratory Failure: a Prospective Observational Multi-center Study

Conditions
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COVID-19 Pneumonia, Tracheal Intubation

Intervention / Treatment
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* Procedure: Endotracheal intubation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Critically ill patient above 18 year old, admitted in the Intensive Care of San Bortolo Hospital, Vicenza, and San Matteo Hospital, Pavia; positive specimen for SARS-COV2 PCR; tracheal intubation for respiratory distress related to SARS COV2 pneumonia Exclusion Criteria: negative specimen for SARS-COV2 PCR out of hospital intubation intubation during cardiac arrest intubation in the contest of general anesthesia for surgery

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Severe COVID pneumonia with ET<br>Severe COVID 19 pneumonia undergoing endotracheal intubation | Procedure: Endotracheal intubation<br>* Airways management in COVID 19 patients pneumonia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major adverse peri-intubation events | The incidence of major adverse peri-intubation events defined as least one events: cardiovascular instability severe Hypoxemia cardiac arrest | intubation procedure, an expected average 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of minor complications in the intubation process in patients admitted in the intensive care | This study will analyze the prevalence of minor complications related to intubation technique in the the Critical Unit. This information will be useful in order to determinate the risk factors associated. | 28 days | 
| Correlation between videolaryngoscope use and incidence of complication compared to the conventional laryngoscopy | Although the video laryngoscope is useful to perform difficult airways management, the benefits associated to its employment is still controversial compared to the conventional laringoscope. | 28 days |