Risk factors of peri-intubation cardiovascular collapse in critically ill patients

Authors : Ömer Emgin, Bişar Ergün

Pages : 110-119

Doi:10.21673/anadoluklin.1310223

View : 42 | Download : 33

Publication Date : 2024-05-29

Article Type : Research Paper

Abstract :Aim: Peri-intubation cardiovascular collapse is a common side effect of tracheal intubation and is associated with increased mortality in critically ill patients. We aimed to determine the potential risk factors associated with peri-intubation cardiovascular collapse. Methods: This is a prospective observational study of patients who were critically ill and undergoing tracheal intubation from August 1, 2022 to February 28, 2023. The primary outcome was peri-intubation cardiovascular collapse. Peri-intubation cardiovascular collapse was defined as systolic blood pressure <65 mm Hg or new or increased need for vasopressors between induction and 2 minutes after tracheal intubation, or cardiac arrest or death between induction of anesthesia and 1 hour after tracheal intubation. Results: A total of 87 eligible patients were included. Of them, 37 (42.5%) had peri-intubation cardiovascular collapse. Multivariate logistic regression analysis showed that a shock index ≥ 0.90 (odds ratio [OR] 9.87, 95% confidence interval [CI] 2.98–32.70, p<0.001) and older age (OR 1.07, 95%CI 1.01–1.13, p=0.013) were independent risk factors for peri-intubation cardiovascular collapse. The mortality rate was similar in patients with and without peri-intubation cardiovascular collapse (56.8% vs. 42.0%; p=0.198). Conclusion: The incidence of peri-intubation cardiovascular collapse is high in critically ill patients. Precautions should be taken because of the increased risk of peri-intubation cardiovascular collapse in elderly patients and patients with a shock index ≥ 0.90.
Keywords : Endotrakeal entübasyon, hava yolu yönetimi, kardiyovasküler kollaps, mortalite, şok indeks, yoğun bakım ünitesi