6/29/23, 1:44 AM PreVent Pathway Feedback Search Clinical Topics Home Studies PreVent PreVent Trial question What is the role of bag-mask ventilation among critically ill adult patients undergoing tracheal intubation? Study design Multi-center Open label RCT Population Characteristics of study participants 44.0% female N = 401 56.0% male 401 patients (175 female, 226 male) Inclusion criteria: ICU adult patients undergoing tracheal intubation Key exclusion criteria: the urgency of intubation precludes randomization, the operator feels a specific approach to ventilation between induction and intubation is required or contraindicated, pregnancy, incarceration Interventions N=199 manual ventilation (bag-mask ventilation between induction and laryngoscopy) N=202 no manual ventilation (no bag-mask ventilation; except after a failed attempt at laryngoscopy, as a treatment for hypoxemia) Primary outcome Median lowest oxygen saturation 96.0 % 96 93 72.0 % 48.0 % Significant increase https://web.pathway.md/studies/recODhHKjHNPWXRlz 1/2 6/29/23, 1:45 AM PreVent Pathway 24.0 % NNH = 33 0.0 % Manual ventilation No manual ventilation Significant increase in median lowest oxygen saturation (96% vs. 93%; AD 3.9%, 95% CI 1.4 to 6.5) Secondary outcomes Borderline significant decrease in lowest oxygen saturation of < 80% (10.9% vs. 22.8%; RR 0.48, 95% CI 0.3 to 0.77) No significant difference in death before hospital discharge (35.7% vs. 35.6%; RR 1, 95% CI 0.77 to 1.3) Significant decrease in median oxygen saturation decline (1% vs. 5%; ARD -4.5, 95% CI -6.8 to -2.2) Safety outcomes No significant differences in operator-reported aspiration, new opacity on chest radiography in the 48 hours after tracheal intubation. Significant difference in oxygen saturation of < 90% (29.5% vs. 40.1%). Conclusion In ICU adult patients undergoing tracheal intubation, manual ventilation was superior to no manual ventilation with respect to median lowest oxygen saturation. Reference Jonathan D Casey, David R Janz, Derek W Russell et al. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2019 Feb 28;380(9):811-821. Open reference URL https://web.pathway.md/studies/recODhHKjHNPWXRlz 2/2