{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T18:26:00Z","timestamp":1787077560488,"version":"build-2736575974"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"8","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"Department of War","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006108","name":"NIH\/National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["5UL1TR002243"],"award-info":[{"award-number":["5UL1TR002243"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NIH\/NCATS","award":["U24TR004437-02"],"award-info":[{"award-number":["U24TR004437-02"]}]},{"name":"Vanderbilt Trial Innovation Center"},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["5T32GM108554"],"award-info":[{"award-number":["5T32GM108554"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Direct versus Video Laryngoscope"},{"name":"Pragmatic Trial Examining Oxygenation Prior to Intubation"},{"DOI":"10.13039\/100014044","name":"59th Medical Wing","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014044","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The neuromuscular blockade dose may affect intubation success on the first attempt, thereby impacting outcomes for patients undergoing emergency tracheal intubation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the association between rocuronium dose and tracheal intubation outcomes among adults undergoing emergency tracheal intubation in the emergency department (ED) and intensive care unit (ICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of data from two multicenter randomized controlled trials studying airway management in the ED and ICU. We compared patient characteristics and intubation outcomes between patients receiving high-dose (&amp;gt;1.2\u2009mg\/kg) versus standard-dose (\u22641.2\u2009mg\/kg) rocuronium. The primary outcome was successful intubation on the first attempt. We used propensity matching to account for measured potential confounders, stratified by setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Participating sites included 9 EDs and 24 ICUs in the United States. Among 2440 patients in the trial datasets, we included the 1822 (74.7%) patients who received rocuronium in the current analysis. Of these, 720 (39.5%) received high-dose rocuronium, and 1102 (60.5%) received standard-dose rocuronium. Participants receiving high-dose rocuronium had a higher probability of successful intubation on the first attempt (adjusted relative risk [RR] 1.07, 95% confidence interval [CI] 1.02-1.12). This difference in the primary outcome was not present for ED intubations (adjusted RR 0.97, 95% CI 0.89-1.04) but was present for ICU intubations (adjusted RR 1.13, 95% CI 1.06-1.20).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this secondary analysis, high-dose rocuronium (&amp;gt;1.2\u2009mg\/kg) was associated with higher first-attempt success. Given the potential for unmeasured confounding, these findings warrant evaluation in a randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajrccm\/aamag203","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:35:46Z","timestamp":1776339346000},"page":"1740-1749","source":"Crossref","is-referenced-by-count":0,"title":["Rocuronium dose and first-attempt intubation success in the critically ill: secondary analysis of two multicenter trials"],"prefix":"10.1093","volume":"212","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5621-441X","authenticated-orcid":false,"given":"Michael D","family":"April","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Brooke Army Medical Center , San Antonio, TX,","place":["United States"]},{"name":"Uniformed Services University Department of Military and Emergency Medicine, , Bethesda, MD,","place":["United 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