The premise of this debate lies in the fact that most board-certified critical care physicians are internists and not anesthesiologists. Furthermore, I assume that the implied question is, “Should a nonanesthesiology intensivist call an anesthesiologist (often not an intensivist) to intubate a critically ill patient?”
Complications occur frequently during ICU intubations. Anesthesiologists generally are viewed as the airway experts. Hence, this debate seems over before it begins. However, let us review the available data closely, and it will become evident that an anesthesiologist is not the clear solution to reduce complications during ICU intubations. Rather,
1. Complications are common in critical illness, regardless of intubator;
2. Intensivists and anesthesiologists each bring distinct skills to the bedside, and it is not clear which skill set is more important; and
3. A structured approach that addresses the known risks of ICU intubations is more important than the medical specialty.