Intubation of the airway is the first and foremost step in care of the
critically ill patient requiring mechanical ventilation. During the l
ast decade, options for airway management, particularly in the patient
with a difficult airway, have expanded substantially. New devices, te
chniques, and pharmacologic agents to facilitate intubation have emerg
ed. Our understanding of the complications and limitations of translar
yngeal intubation and tracheotomy has also evolved. The purpose of thi
s article is to incorporate this new information into a bas of current
and practical knowledge of intubation of the critically ill adult pat
ient.