Airway management in the intensive care unit

Airway management practices in the intensive care unit (ICU) are still evolving, evidenced by an increasing proliferation of guidelines/algorithms in recent years as well ongoing studies focusing on equipment choices such as videolaryngoscopes. Specific considerations relate to the out-of-theatre environment and the physiological state in this patient population. Airway management in ICU is ultimately a multifaceted process spanning team training, simulation, preassessment, preparation, positioning of the patient, equipment decisions and guidelines/algorithm adherence including those covering the management of coronavirus disease (COVID-19). Emergency front-of-neck access (FONA) should be taught to all staff and standardized equipment made available. This updated article highlights the growing evidence supporting the use of videolaryngoscopy in the critical care setting as well as the use of checklists, and highlights the factors a multidisciplinary team must navigate when approaching airway management in the ICU.