RT Journal Article
A1 Schober, Patrick
A1 Loer, Stephan Alexander
A1 Schwarte, Lothar Andreas
T1 Noninvasive Airway Management of Comatose Patients With Acute Poisoning
JF JAMA
JO JAMA
YR 2024
DO 10.1001/jama.2024.1417
VO 331
IS 17
SP 1502
OP 1503
SN 0098-7484
AB To the Editor A recent study suggested clinical benefits of noninvasive airway management in comatose patients with acute poisoning. An accompanying editorial lauded the study as a practice-changing trial providing rigorous evidence. Although we have recommended against indiscriminate intubation of patients based on a low Glasgow Coma Scale (GCS) score, we are concerned about the ability of this study to provide conclusive evidence allowing a paradigm shift in clinical practice.The clinical benefit reported for the primary outcome was driven by a reduced intensive care unit (ICU) admission rate and consequently shorter ICU length of stay in the intervention group. Given that patients receiving intubation typically require ICU care, the study’s design inevitably resulted in shorter ICU stays for the intervention group. This finding, therefore, does not justify avoiding intubation of intoxicated patients. It would have been important to show that withholding intubation is safe and improves clinically relevant patient outcomes.
RD 5/20/2024
UL https://doi.org/10.1001/jama.2024.1417