OBJECTIVE: Arterial hypotension is a recognized complication of emergency intubation, but the consequence of this event is poorly described. Our aim was to identify the incidence of postintubation hypotension (PIH) after emergency intubation and to determine its association with inhospital mortality. METHODS: Retrospective cohort study of tracheal intubations performed in a large, urban emergency department over a 1-year period. Patients were included if they were older than 17 years and had no systolic blood pressure measurements less than 90 mm Hg for 30 consecutive minutes before intubation. Patients were analyzed in 2 groups, those with PIH, defined as any recorded systolic blood pressure less than 90 mm Hg within 60 minutes of intubation, and those with no PIH. The primary outcome was inhospital mortality. RESULTS: Of 465 patients who underwent emergency intubation, 336 met inclusion criteria and were analyzed. Postintubation hypotension occurred in 79 (23%) of 336 patients. Patients with PIH had significantly higher inhospital mortality (33% vs 21%; 95% confidence interval for 12% difference, 1%-23%) and longer mean intensive care length of stay (LOS) (9.7 vs 5.9 days, P < .01) and hospital LOS (17.0 vs 11.4 days, P < .01). Postintubation hypotension remained a significant predictor of inhospital mortality after adjusting for confounding using multivariable logistic regression analysis (odds ratio, 1.9; 95% confidence interval, 1.1-3.5). CONCLUSION: Postintubation hypotension occurs in almost one quarter of normotensive patients undergoing emergency intubation. Postintubation hypotension is independently associated with higher inhospital mortality and longer intensive care unit and hospital LOS.
OBJECTIVE: Arterial hypotension is a recognized complication of emergency intubation, but the consequence of this event is poorly described. Our aim was to identify the incidence of postintubation hypotension (PIH) after emergency intubation and to determine its association with inhospital mortality. METHODS: Retrospective cohort study of tracheal intubations performed in a large, urban emergency department over a 1-year period. Patients were included if they were older than 17 years and had no systolic blood pressure measurements less than 90 mm Hg for 30 consecutive minutes before intubation. Patients were analyzed in 2 groups, those with PIH, defined as any recorded systolic blood pressure less than 90 mm Hg within 60 minutes of intubation, and those with no PIH. The primary outcome was inhospital mortality. RESULTS: Of 465 patients who underwent emergency intubation, 336 met inclusion criteria and were analyzed. Postintubation hypotension occurred in 79 (23%) of 336 patients. Patients with PIH had significantly higher inhospital mortality (33% vs 21%; 95% confidence interval for 12% difference, 1%-23%) and longer mean intensive care length of stay (LOS) (9.7 vs 5.9 days, P < .01) and hospital LOS (17.0 vs 11.4 days, P < .01). Postintubation hypotension remained a significant predictor of inhospital mortality after adjusting for confounding using multivariable logistic regression analysis (odds ratio, 1.9; 95% confidence interval, 1.1-3.5). CONCLUSION: Postintubation hypotension occurs in almost one quarter of normotensive patients undergoing emergency intubation. Postintubation hypotension is independently associated with higher inhospital mortality and longer intensive care unit and hospital LOS.
Authors: Ramiro Manzano-Nunez; Juan Pablo Herrera-Escobar; Joseph DuBose; Tal Hörer; Samuel Galvagno; Claudia Patricia Orlas; Michael W Parra; Federico Coccolini; Massimo Sartelli; Juan Camilo Falla-Martinez; Alberto Federico García; Julian Chica; Maria Paula Naranjo; Alvaro Ignacio Sanchez; Camilo Jose Salazar; Luis Eduardo Calderón-Tapia; Valeria Lopez-Castilla; Paula Ferrada; Ernest E Moore; Carlos A Ordonez Journal: Eur J Trauma Emerg Surg Date: 2018-03-23 Impact factor: 3.693
Authors: Gabriel Wardi; Julian Villar; Thien Nguyen; Anuja Vyas; Nicholas Pokrajac; Anushirvan Minokadeh; Daniel Lasoff; Christopher Tainter; Jeremy R Beitler; Rebecca E Sell Journal: Resuscitation Date: 2017-10-12 Impact factor: 5.262
Authors: Carl Mathias Karlsson; Michael W Donnino; Hans Kirkegaard; Michael N Cocchi; Maureen Chase; Lars W Andersen Journal: J Emerg Med Date: 2017-01-17 Impact factor: 1.484
Authors: Nicholas M Mohr; Stephen G Pape; Dan Runde; Amy H Kaji; Ron M Walls; Calvin A Brown Journal: Acad Emerg Med Date: 2020-07-20 Impact factor: 3.451
Authors: Kohei Hasegawa; Yusuke Hagiwara; Taichi Imamura; Takuyo Chiba; Hiroko Watase; Calvin A Brown; David Fm Brown Journal: Int J Emerg Med Date: 2013-04-24