{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T22:52:45Z","timestamp":1787784765515,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2024\u201002773"],"award-info":[{"award-number":["2024\u201002773"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Endotracheal intubation is a common procedure in the intensive care. However, it is associated with a high incidence of complications, primarily hypotension and hypoxia. Although guidelines advocate the use of checklists for intubation, studies on their effectiveness are limited. The aim was to investigate whether the implementation of a checklist for intubation in an intensive care unit is associated with a reduction in immediate intubation\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We conducted an observational before and after study, implementing an intubation checklist before the second period. Adult patients intubated between December 2022 and August 2024 at Karolinska University Hospital were included. Data regarding intubations were collected from a quality registry. The primary outcome was a SpO<jats:sub>2<\/jats:sub> &lt;\u200990% by pulse oximetry or systolic arterial pressure (SAP) &lt;\u200990\u2009mmHg within 5\u2009min of intubation. Chi\u2010square or Fisher's exact test was used for the comparison of proportions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 97 patients were included. There was no significant difference in the primary outcomes of SpO<jats:sub>2<\/jats:sub>\u2009&lt;\u200990% (30% vs. 21%, <jats:italic>p<\/jats:italic>\u2009=\u20090.29) or SAP &lt;\u200990\u2009mmHg (34% vs. 32%, <jats:italic>p<\/jats:italic>\u2009=\u20090.80) before and after checklist implementation. There was no difference in the secondary outcomes of lowest median SpO<jats:sub>2<\/jats:sub> from intubation until up to 5\u2009min after, surgical airway intervention, cardiovascular collapse, cardiac arrest, oesophageal intubation, severe arrhythmia, or death between the periods. Apnoeic oxygenation, either by standard nasal cannula or high\u2010flow nasal cannula, was used more frequently after checklist implementation (7% vs. 36%, <jats:italic>p<\/jats:italic>\u2009=\u20090.005). Preoxygenation with non\u2010invasive ventilation was used in 33% of cases in the standard period compared to 48% in the checklist period (<jats:italic>p<\/jats:italic>\u2009=\u20090.19).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study on implementing a checklist for intubation of critically ill adults, we could not demonstrate a reduction in immediate intubation\u2010related complications. However, the use of apnoeic oxygenation increased in the checklist period, highlighting the checklist's value as a cognitive aid when preparing for this common yet perilous procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Editorial Comment<\/jats:title><jats:p>This time interrupted series analysis looked at implementation of a checklist for preparing and planning intubation of ICU patients, where it is recognized that there is risk for respiratory or circulatory adverse events. The findings here from one center showed that implementation of new, detailed checklist\u2010based preparation can affect practice, and that when advanced non\u2010invasive positive pressure ventilatory support is routinely applied, hypoxia can be less frequent then before these were routinely implemented.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">Clinicaltrials.gov<\/jats:ext-link> identifier: (NCT06791317)<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.70103","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T07:30:21Z","timestamp":1753169421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Checklist Implementation on Endotracheal Intubation\u2010Related Complications in Critically Ill Adults\u2014A Retrospective Before and After Study"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9386-2795","authenticated-orcid":false,"given":"Atosa","family":"Nejatian","sequence":"first","affiliation":[{"name":"Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology, Section for Anaesthesiology and Intensive Care Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida\u2010Maria","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology, Section for Anaesthesiology and Intensive Care Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrika","family":"Thor\u00f6","sequence":"additional","affiliation":[{"name":"Perioperative 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