Table 1.
Patient and operator demographics
| Characteristic |
Paralytic % |
95% CI |
No Paralytic % |
95% CI |
P Value |
|---|---|---|---|---|---|
| (n = 496) | (n = 168) | ||||
| Age, yr, median, IQR | 59 | IQR, 51–68 | 59 | IQR, 47–70 | 0.62 |
| Patient sex | |||||
| Male | 59.7 (296) | 47–67 | 50.6 (84) | 52–69 | 0.05 |
| DACs | |||||
| Total DACs, median, IQR | 1 | IQR, 1–3 | 2 | IQR, 1–4 | <0.001 |
| None | 21.7 (108) | 18.2–25.6 | 15.6 (26) | 10.4–21.97 | 0.10 |
| Cervical immobilization | 2.2 (11) | 1.1–3.9 | 4.2 (7) | 1.7–8.4 | 0.18 |
| Blood in airway | 14.9 (74) | 11.9–18.3 | 16.2 (27) | 10.9–22.6 | 0.71 |
| Vomit in airway | 5.03 (25) | 3.3–7.3 | 7.2 (12) | 3.8–12.2 | 0.33 |
| Facial/neck trauma | 0.6 (3) | 0.12–1.8 | 0.6 (1) | 0.02–3.3 | 1.00 |
| Obesity | 27.8 (138) | 23.9–31.9 | 33.5 (56) | 26.4–41.2 | 0.17 |
| Short neck | 22.5 (112) | 18.9–26.5 | 28.1 (47) | 21.5–35.6 | 0.14 |
| Large tongue | 12.1 (60) | 9.3–15.3 | 16.8 (28) | 11.4–23.3 | 0.15 |
| Airway edema | 7.0 (35) | 4.95–9.7 | 10.8 (18) | 6.5–16.5 | 0.14 |
| Small mandible | 13.9 (69) | 10.97–17.24 | 19.2 (32) | 13.5–25.96 | 0.11 |
| Hypoxemia | 26.2 (130) | 22.3–30.3 | 29.9 (50) | 23.1–37.5 | 0.37 |
| Hypotension | 21.3 (106) | 17.8–25.2 | 28.1 (47) | 21.5–35.6 | 0.07 |
| Sedatives | |||||
| None | 0.2 (1) | 0.0–1.1 | 11.3 (19) | 6.95–17.1 | |
| Etomidate | 83.3 (414) | 79.9–86.6 | 34.5 (58) | 27.4–42.2 | |
| Ketamine | 8.9 (44) | 6.5–11.7 | 39.3 (66) | 31.9–47.1 | <0.001 |
| Midazolam | 2.4 (12) | 1.3–4.2 | 2.4 (4) | 0.65–5.98 | |
| Propofol | 5.0 (25) | 3.3–7.4 | 11.3 (19) | 6.9–17.1 | |
| Combination | 0 (0) | 0–0.07 | 1.2 (2) | 0.14–4.2 | |
| Paralytics | — | ||||
| None | 0 (0) | 0–0.74 | 100 (168) | — | |
| Succinylcholine | 65.1 (323) | 60.7–69.3 | — | — | |
| Rocuronium | 32.7 (162) | 28.5–36.98 | — | — | |
| Cisatracurium | 2.2 (11) | 1.1–3.9 | — | ||
| Reason for intubation | 0.55 | ||||
| Airway protection | 21.3 (106) | 17.8–25.2 | 21.4 (36) | 15.5–28.4 | |
| Respiratory failure | 47.2 (234) | 42.7–51.7 | 42.9 (72) | 35.3–50.7 | |
| Patient control | 1.2 (6) | 0.4–2.6 | 1.8 (3) | 0.4–5.1 | |
| Cardiac arrest | 1.0 (5) | 0.3–2.3 | 7.1 (12) | 3.7–12.1 | |
| Hypoxemia | 22.1 (110) | 18.6–26.1 | 20.8 (35) | 15.0–27.8 | |
| Hemodynamic instability | 3.2 (16) | 1.9–5.2 | 3.6 (6) | 1.3–7.6 | |
| Severe acidosis | 3.8 (19) | 2.3–5.9 | 2.4 (4) | 0.6–5.9 | |
| Operator PGY level | 0.005 | ||||
| 1 | 7.7 (38) | 5.5–10.4 | 6.0 (10) | 2.9–10.7 | |
| 2 | 19.8 (98) | 16.3–23.5 | 11.9 (20) | 7.4–17.8 | |
| 3 | 12.9 (64) | 10.1–16.2 | 10.7 (18) | 6.5–16.4 | |
| 4 | 24 (119) | 20.3–28.0 | 27.0 (45) | 20.3–34.2 | |
| 5 | 24.2 (120) | 20.5–28.2 | 27.4 (46) | 20.8–34.8 | |
| 6 | 9.7 (48) | 7.2–12.6 | 12.5 (21) | 7.9–18.5 | |
| Attending | 1.8 (9) | 0.8–3.4 | 4.8 (8) | 2.1–9.2 | |
| Device used | 0.10 | ||||
| Direct laryngoscopy | 20.3 (101) | 17–24.2 | 11.3 (19) | 6.9–17.1 | |
| GlideScope | 17.5 (87) | 14.3–21.2 | 20.2 (34) | 14.4–27.1 | |
| C-MAC | 61 (302) | 56.4–65.2 | 67.2 (113) | 59.6–74.3 | |
| Other video laryngoscope | 1.2 (6) | 0.4–2.6 | 1.2 (2) | 0.1–4.2 |
Definition of abbreviations: CI = confidence interval; DACs = difficult airway characteristics; IQR = interquartile range; PGY = postgraduate year of resident.