02 February 2016 : Clinical Research
Incidence of and Risk Factors For Post-Intubation Hypotension in the Critically Ill
Nathan J. SmischneyABCDEF, Onur DemirciABDEF, Daniel A. DiedrichBDEF, David W. BarbaraBDEF, Benjamin J. SandefurBDEF, Sangita TrivediABDEF, Sean McGarryBDEF, Rahul KashyapABCDEDOI: 10.12659/MSM.895919
Med Sci Monit 2016; 22:346-355
Abstract
BACKGROUND: We aim to report the incidence of post-intubation hypotension in the critically ill, to report in-hospital mortality and length of stay in those who developed post-intubation hypotension, and to explore possible risk factors associated with post-intubation hypotension.
MATERIAL AND METHODS: Adult (≥18 years) ICU patients who received emergent endotracheal intubation were included. We excluded patients if they were hemodynamically unstable 60 minutes pre-intubation. Post-intubation hypotension was defined as the administration of any vasopressor within 60 minutes following intubation.
RESULTS: Twenty-nine patients developed post-intubation hypotension (29/147, 20%). Post-intubation hypotension was associated with increased in-hospital mortality (11/29, 38% vs. 19/118, 16%) and length of stay (21 [10–37] vs. 12 [7–21] days) on multivariate analysis. Three risk factors for post-intubation hypotension were identified on multivariate analysis: 1) decreasing mean arterial pressure pre-intubation (per 5 mmHg decrease) (p-value=0.04; 95% CI 1.01–1.55); 2) administration of neuromuscular blockers (p-value=0.03; 95% CI 1.12–6.53); and 3) intubation complication (p-value=0.03; 95% CI 1.16–15.57).
CONCLUSIONS: Post-intubation hypotension was common in the ICU and was associated with increased in-hospital mortality and length of stay. These patients were more likely to have had lower mean arterial pressure prior to intubation, received neuromuscular blockers, or suffered a complication during intubation.
Keywords: Hemodynamics, Critical Illness - epidemiology, Hospital Mortality, Hypotension - physiopathology, Incidence, Intubation, Intratracheal - adverse effects, Length of Stay, Multivariate Analysis, Risk Factors, Severity of Illness Index
Editorial
01 May 2024 : Editorial
Editorial: First Regulatory Approval for Adoptive Cell Therapy with Autologous Tumor-Infiltrating Lymphocytes (TILs) – Lifileucel (Amtagvi)DOI: 10.12659/MSM.944927
Med Sci Monit 2024; 30:e944927
In Press
26 Mar 2024 : Clinical Research
New Computerized Planning Algorithm and Clinical Testing of Optimized Nuss Bar Design for Patients with Pec...Med Sci Monit In Press; DOI: 10.12659/MSM.943705
07 May 2024 : Clinical Research
Treatment of AVN-Induced Proximal Pole Scaphoid Nonunion Using a Fifth and Fourth Extensor Compartmental Ar...Med Sci Monit In Press; DOI: 10.12659/MSM.944553
16 Mar 2024 : Clinical Research
Diagnostic Efficiency of ACR-TIRADS Score for Differentiating Benign and Malignant Thyroid Nodules of Vario...Med Sci Monit In Press; DOI: 10.12659/MSM.943228
08 May 2024 : Clinical Research
Effect of Individualized PEEP Guided by Driving Pressure on Diaphragm Function in Patients Undergoing Lapar...Med Sci Monit In Press; DOI: 10.12659/MSM.944022
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952