Airway Management in Critical Illness: An Update

Chest. 2020 Apr;157(4):877-887. doi: 10.1016/j.chest.2019.10.026. Epub 2019 Nov 9.


Expertise in airway management is a vital skill for any provider caring for critically ill patients. A growing body of literature has identified the stark difference in periprocedural outcomes of elective intubation in the operating room when compared with emergency intubation in the ICU. A number of strategies to reduce the morbidity and mortality associated with airway management in the critically ill have been described. In this review, we provide an updated framework for airway assessment before direct laryngoscopy and video laryngoscopy, and use of newer pharmacologic agents; comment on current concepts in tracheal intubation in the ICU; and address human factors around critical decision-making during ICU airway management.

Keywords: ICU intubation; airway management; difficult airway.

Publication types

  • Review

MeSH terms

  • Airway Management* / methods
  • Airway Management* / trends
  • Critical Illness / therapy*
  • Emergency Medical Services*
  • Humans
  • Intubation, Intratracheal / methods
  • Laryngoscopy / methods