A Multicenter, Randomized Trial of Ramped Position versus Sniffing Position during Endotracheal Intubation of Critically Ill Adults. Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room.

In this multicenter trial, ramped position did not improve oxygenation during endotracheal intubation of critically ill adults compared to sniffing position. Ramped position may worsen glottic view and increase the number of laryngoscopy attempts required for successful intubation.

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