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The NICO Trial

The NICO Trial


November 29, 2023

Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning

Mazen Kherallah

Summarized by: 

In comatose patients with suspected acute poisoning and a Glasgow Coma Scale score less than 9, does a conservative airway management strategy involving the withholding of intubation lead to better clinical outcomes compared to the routine practice of tracheal intubation, in terms of in-hospital mortality, length of ICU stay, and length of hospital stay?


  • Comatose patients with suspected acute poisoning.

  • Glasgow Coma Scale score < 9.

  • Study conducted in France, including participants from 20 emergency departments and 1 ICU.

  • 225 patients (mean age 33 years; 38% female).


  • Conservative airway management strategy involving withholding of intubation.


  • Routine practice of tracheal intubation.


  • No in-hospital deaths in either group.

  • Clinical benefit in the intervention group (win ratio 1.85; 95% CI, 1.33 to 2.58).

  • Lower proportion of adverse events in the intervention group (6% vs 14.7%; absolute risk difference, 8.6%).

  • Pneumonia occurrence: 6.9% in the intervention group and 14.7% in the control group (absolute risk difference, −7.8%).


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