Tracheal Intubation With Stylet Have High First Pass Intubation Success Rate

"The results of this study have the potential to change airway management practice in critically ill patients. Conventionally, a stylet is used with the tracheal tube when the first attempt at tracheal intubation fails," said Dr Sheila Nainan Myatra in an editorial comment.

The STYLETO trial was a multicentre randomized controlled trial, conducted in 32 intensive care units. The researchers included a total of 999 patients and randomly assigned them to the tracheal tube + stylet group(n=501)or tracheal tube alone group (n=498). The major outcome assessed was the proportion of patients with first-attempt intubation success. The researchers also evaluated the proportion of patients with complications and serious adverse events related to tracheal intubation.

Key findings of the study were:

• Upon analysis, the researchers found that first-attempt intubation success occurred in 392 patients (78.2%) in the tracheal tube + stylet group and 356 (71.5%) in the tracheal tube alone group (absolute risk difference, 6.7).
• They noted that a total of 194 patients had tracheal intubation related complication in the tracheal tube + stylet group and 200 patients in the tracheal tube alone group (absolute risk difference, − 1.5).
• They also noted that the incidence of serious adverse events was 4.0% and 3.6%, respectively (absolute risk difference, 0.4).

The authors concluded, "Among critically ill adults undergoing tracheal intubation, using a stylet improves first-attempt intubation success."

For further information:

https://link.springer.com/article/10.1007%2Fs00134-021-06417-y