Portal de Periódicos da CAPES

Incidence of and Risk Factors For Post-Intubation Hypotension in the Critically Ill

2016; International Scientific Information Inc.; Volume: 22; Linguagem: Inglês

10.12659/msm.895919

1643-3750

Nathan J. Smischney, Onur Demirci, Daniel A. Diedrich, David W. Barbara, Benjamin J. Sandefur, Sangita Trivedi, Sean D. McGarry, Rahul Kashyap,

Cardiac, Anesthesia and Surgical Outcomes

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/Methods:Adult (³18 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-val-ue=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.