6/27/23, 11:45 PM BOUGIE Pathway Feedback Search Clinical Topics Home Studies BOUGIE BOUGIE Trial question Is the use of bougie superior to an endotracheal tube with stylet in critically ill adults undergoing tracheal intubation? Study design Multi-center Open label RCT Population Characteristics of study participants 41.0% female N = 1102 59.0% male 1102 patients (452 female, 650 male) Inclusion criteria: critically ill adult patients undergoing tracheal intubation Key exclusion criteria: pregnancy, incarceration, immediate need for tracheal intubation without time for randomization, operator determines that use of a bougie or a stylet is required or contraindicated Interventions N=556 bougie (use of bougie for the first attempt at tracheal intubation) N=546 stylet (use of endotracheal tube with a malleable stylet for the first attempt at tracheal intubation) Primary outcome Successful intubation on first attempt 83.0 % 83 80.4 62.3 % 41.5 % 20.8 % No significant difference 0.0 % https://web.pathway.md/studies/recXEjaZ4oSlSqeK3 1/2 6/27/23, 11:45 PM BOUGIE Pathway Bougie Stylet No significant difference in successful intubation on the first attempt (80.4% vs. 83%; ARD -2.6, 95% CI -7.3 to 2.2) Secondary outcomes No significant difference in severe hypoxemia (11% vs. 8.8%; ARD 2.2, 95% CI -1.6 to 6) Significant decrease in the rate of death before 28 days (27.3% vs. 33.7%; ARD -6.4, 95% CI -12 to -0.8) No significant difference in ventilator-free days (24 days vs. 22 days; DIM 2, 95% CI 0.5 to 6) Safety outcomes No significant differences in airway complications, pneumothorax after intubation. Conclusion In critically ill adult patients undergoing tracheal intubation, bougie was not superior to stylet with respect to successful intubation on the first attempt. Reference Brian E Driver, Matthew W Semler, Wesley H Self et al. Effect of Use of a Bougie vs Endotracheal Tube With Stylet on Successful Intubation on the First Attempt Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial. JAMA. 2021 Dec 28;326(24):2488-2497. Open reference URL https://web.pathway.md/studies/recXEjaZ4oSlSqeK3 2/2