학술논문
Risk factors for and prediction of post-intubation hypotension in critically ill adults: A multicenter prospective cohort study.
Document Type
article
Author
Nathan J Smischney; Rahul Kashyap; Ashish K Khanna; Ernesto Brauer; Lee E Morrow; Mohamed O Seisa; Darrell R Schroeder; Daniel A Diedrich; Ashley Montgomery; Pablo Moreno Franco; Uchenna R Ofoma; David A Kaufman; Ayan Sen; Cynthia Callahan; Chakradhar Venkata; Gozde Demiralp; Rudy Tedja; Sarah Lee; Mariya Geube; Santhi I Kumar; Peter Morris; Vikas Bansal; Salim Surani; SCCM Discovery (Critical Care Research Network of Critical Care Medicine) HEMAIR Investigators Consortium
Source
PLoS ONE, Vol 15, Iss 8, p e0233852 (2020)
Subject
Language
English
ISSN
1932-6203
Abstract
ObjectiveHypotension following endotracheal intubation in the ICU is associated with poor outcomes. There is no formal prediction tool to help estimate the onset of this hemodynamic compromise. Our objective was to derive and validate a prediction model for immediate hypotension following endotracheal intubation.MethodsA multicenter, prospective, cohort study enrolling 934 adults who underwent endotracheal intubation across 16 medical/surgical ICUs in the United States from July 2015-January 2017 was conducted to derive and validate a prediction model for immediate hypotension following endotracheal intubation. We defined hypotension as: 1) mean arterial pressure ResultsPost-intubation hypotension developed in 344 (36.8%) patients. In the full cohort, 11 variables were independently associated with hypotension: increasing illness severity; increasing age; sepsis diagnosis; endotracheal intubation in the setting of cardiac arrest, mean arterial pressure ConclusionsA novel multivariable risk score predicted post-intubation hypotension with accuracy in both unstable and stable critically ill patients.Study registrationClinicaltrials.gov identifier: NCT02508948 and Registered Report Identifier: RR2-10.2196/11101.