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Cited by 120Airway Management and Intubation TechniquesRespiratory Support and MechanismsTracheal and airway disorders

Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study

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Perbet, Sebastien, De Jong, Audrey, Delmas, Julie, Futier, Emmanuel, Pereira, Bruno, Jaber, Samir, Constantin, Jean-Michel·2015·Critical Care
DOI 10.1186/s13054-015-0975-9PMC PMC4495680
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Abstract

Introduction: Severe cardiovascular collapse (CVC) is a life-threatening complication after emergency endotracheal intubation (ETI) in the ICU. Many factors may interact with hemodynamic conditions during ETI, but no study to date has focused on factors associated with severe CVC occurrence. This study assessed the incidence of severe CVC after ETI in the ICU and analyzed the factors predictive of severe CVC. Methods: This was a secondary analysis of a prospective multicenter study of 1,400 consecutive intubations at 42 ICUs. The incidence of severe CVC was assessed in patients who were hemodynamically stable (mean arterial blood pressure >65 mmHg without vasoactive drugs) before intubation, and the factors predictive of severe CVC were determined by multivariate analysis based on patient and procedure characteristics. Results: Severe CVC occurred following 264 of 885 (29.8 %) intubation procedures. A two-step multivariate analysis showed that independent risk factors for CVC included simple acute physiologic score II regardless of age (odds ratio (OR) 1.02, p < 0.001), age 60–75 years (OR 1.96, p < 0.002 versus <60 years) and >75 years (OR 2.81, p < 0.001 versus <60 years), acute respiratory failure as a reason for intubation (OR 1.51, p = 0.04), first intubation in the ICU (OR 1.61, p = 0.02), noninvasive ventilation as a preoxygenation method (OR 1.54, p = 0.03) and inspired oxygen concentration >70 % after intubation (OR 1.91, p = 0.001). Comatose patients who required ETI were less likely to develop CVC during intubation (OR 0.48, p = 0.004). Conclusions: CVC is a frequent complication, especially in old and severely ill patients intubated for acute respiratory failure in the ICU. Specific bundles to prevent CVC may reduce morbidity and mortality related to intubation of these high-risk, critically ill patients. Trial registration: clinicaltrials.gov NCT01532063; registered 8 February 2012.

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  • RSI in underresuscitated patients may result in unintended poor outcomes, including critical hypoxemia and circulatory collapse.

    “RSI in underresuscitated patients may result in unintended poor outcomes, including critical hypoxemia and circulatory collapse.82,83”

    From Airway Management in Trauma (2018) · cites this paper as [83]

    The Results report desaturation during intubation, and the Discussion addresses severe cardiovascular collapse after intubation. The Discussion also describes possible hypovolemia before induction, but it does not establish that underresuscitation specifically increases the risk of either outcome during rapid sequence intubation. The paper gives no page numbers for these passages. (LLM, conf=0.82)

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Cited by

Sorted by citations

Authors
Perbet, S., De Jong, A., Delmas, J., Futier, E., Pereira, B., Jaber, S., & Constantin, J.-M.
Affiliations
  • Centre Hospitalier Universitaire de Clermont-Ferrand (FR)
  • Inserm (FR)
Corresponding author
Constantin, Jean-Michel
ORCID
Venue
Critical Care
Publisher
Springer Science and Business Media LLC
Published
2015-12
Volume
19
Issue
1
Pages
257-257
ISSN
1364-8535 (ISSN-L)
DOI
10.1186/s13054-015-0975-9
PMC
PMC4495680
OpenAlex
W2132153923
Cited by
120
References
0
Citations by year
2026: 9 · 2025: 7 · 2024: 7 · 2023: 10 · 2022: 19 · 2021: 14 · 2020: 12 · 2019: 7 · 2018: 10 · 2017: 12 · 2016: 10 · 2015: 2 · 2014: 1
FWCI
13.63
Type
journal article
Language
en
Open access
Licence
Locations
  • Critical Care (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Tracheal and airway disorders
Keywords
cardiovascular collapse, endotracheal intubation, intubation complications, risk factors, incidence, acute respiratory failure, APACHE II score, age, inspired oxygen concentration, comatose patients, critically ill patients, intensive care unit, hemodynamic stability, prevention bundle, cardiac arrest
MeSH terms
Age Factors, Aged, Humans, Intensive Care Units, Intubation, Intratracheal, Middle Aged, Oxygen Consumption, Prospective Studies, Respiratory Insufficiency, Risk Factors, Shock, Incidence, Multivariate Analysis, APACHE, Noninvasive Ventilation

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