STUDY OBJECTIVE To examine the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt and severe complications during tracheal intubation of critically ill adults in an emergency department (ED) or ICU. METHODS We performed a secondary analysis of data from 2 multicenter randomized trials in critically ill adults undergoing tracheal intubation in an ED or ICU. Using a generalized linear mixed-effects model with prespecified baseline covariates, we examined the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt (primary outcome) and severe complications during tracheal intubation (secondary outcome). RESULTS Among the 2,440 patients in the trial data sets, 2,339 (95.9%) were included in the current analysis; 475 patients (20.3%) received succinylcholine and 1,864 patients (79.7%) received rocuronium. Successful intubation on the first attempt occurred in 375 patients (78.9%) who received succinylcholine and 1,510 patients (81.0%) who received rocuronium (an adjusted odds ratio of 0.87; 95% CI 0.65 to 1.15). Severe complications occurred in 67 patients (14.1%) who received succinylcholine and 456 patients (24.5%) who received rocuronium (adjusted odds ratio, 0.88; 95% CI 0.62 to 1.26). CONCLUSION Among critically ill adults undergoing tracheal intubation, the incidences of successful intubation on the first attempt and severe complications were not significantly different between patients who received succinylcholine and patients who received rocuronium.

中文翻译：

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神经肌肉阻滞剂与紧急气管插管结果之间的关联：随机试验的二次分析。


研究目的 检查接受的神经肌肉阻滞剂 （琥珀胆碱与罗库溴铵） 与急诊科 （ED） 或 ICU 危重症成人首次尝试成功插管和气管插管期间严重并发症之间的关联。方法 我们对 2 项多中心随机试验的数据进行了二次分析，这些试验是在 ED 或 ICU 接受气管插管的危重成人中进行的。使用具有预先指定基线协变量的广义线性混合效应模型，我们检查了接受的神经肌肉阻滞剂（琥珀胆碱与罗库溴铵）与首次尝试成功插管的发生率（主要结果）和气管插管期间严重并发症之间的关联（次要结果）。结果 在试验数据集的 2,440 名患者中，当前分析包括 2,339 名 （95.9%）;475 例患者 （20.3%） 接受琥珀胆碱治疗，1,864 例患者 （79.7%） 接受罗库溴铵治疗。375 例接受琥珀胆碱治疗的患者 （78.9%） 和接受罗库溴铵治疗的 1,510 例患者 （81.0%） 首次尝试插管成功 （校正比值比为 0.87;95% CI 0.65 至 1.15）。接受琥珀胆碱治疗的 67 例患者 （14.1%） 和接受罗库溴铵治疗的 456 例患者 （24.5%） 发生严重并发症 （校正比值比，0.88;95% CI 0.62 至 1.26）。结论 在接受气管插管的危重症成人患者中，接受琥珀胆碱治疗的患者和接受罗库溴铵治疗的患者首次尝试插管成功和严重并发症的发生率差异不显著。