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Karim HMR, Bhattacharjee A, Khandelwal A. Letter to the Editor: Insight into emergency endotracheal intubation in critically ill and strategies beyond equipment. World J Crit Care Med 2026; 15(2): 118845 [PMID: 42272892 DOI: 10.5492/wjccm.v15.i2.118845]
Habib Md Reazaul Karim, Anirban Bhattacharjee, Ankur Khandelwal, Department of Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, Guwahati 781101, Assam, India
Co-first authors: Habib Md Reazaul Karim and Anirban Bhattacharjee.
Author contributions: Karim HMR, Bhattacharjee A and Khandelwal A analyzed the article, performed a literature search, wrote the draft, edited and finalized the manuscript; Karim HMR and Bhattacharjee A have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Habib Md Reazaul Karim, Additional Professor, Department of Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, Silbharal, Changsari, Guwahati 781101, Assam, India. drhabibkarim@gmail.com
Received: January 13, 2026 Revised: January 27, 2026 Accepted: February 10, 2026 Published online: June 9, 2026 Processing time: 129 Days and 3.5 Hours
Abstract
We read the study by Aggarwal et al recently published in World Journal of Critical Care Medicine, assessing the emergency endotracheal intubation (ETI) using two different equipment in critically ill patients and applaud it for choosing a crucial aspect of acute care. ETI remains a high-risk procedure in such patients with significant morbidity. The randomized design and objective outcome measures are notable strengths. Further, the inclusion of operator experience and contextual details enhances understanding of human factors and system-level influences. However, a few aspects warrant further consideration and discussion while adopting the research in clinical practice and future research.
Core Tip: Emergency intubation outcomes in the critically ill depend not only on devices, but also on physiology, preparation, and systems. Recent literature highlights that attention to operator expertise and system-level factors in emergency endotracheal intubation addresses a critical aspect of acute care. Such practice and research therefore, require standardized reporting, pre-intubation optimization, and evidence-based protocols to enhance safety and generalizability across settings.
