The difficult intubation in the ICU

Airway management in the intensive care unit differs from conventional controlled settings such as general anaesthesia in the operating room (OR). Due to adequate patient preparation and positioning in the OR, endotracheal intubation is usually easy to perform. However, in the intensive care setting, endotracheal intubation is often difficult or impossible because patients are not prepared and intubation is immediately necessary without sufficient time for putting together technical and pharmaceutical equipment. As an alternative, non-invasive alternate airway management may be performed. Besides non-invasive ventilation via mask or helmet, the use of Combitube®, EasyTubeTM, and different types of laryngeal mask airway are described, in order to alleviate decision-making in emergency situations such as difficult intubation, vomiting and bleeding patients, small interincisor distance, etc.