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Updated: Jun 18, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Propofol administration for induction is associated with peri-intubation instability in trauma critical care unit
Katherine B Snyder1, Jonathan Gushing2, Celia Quang1
1Department of Surgery, The University of Oklahoma, 800 Stanton L Young Blvd, Oklahoma City, Ok, 73104, USA.
Introduction:
Peri-intubation hypotension is associated with increased hospital length of stay and morbidity. Propofol is associated with alterations in hemodynamics. We hypothesize that using propofol for induction leads to peri-intubation hypotension in trauma critical care patients.
Methods:
Patients that underwent unplanned intubation in the trauma intensive care unit (TICU) were prospectively enrolled. Peri-intubation vitals and medications were recorded to assess hypotension within 10 min of intubation. Patients were divided into propofol (PROP) or other medication (OTR) groups.
Results:
Data was complete for 69 patients; 31 PROP and 38 OTR. In OTR there was an 8.8-point (-21.1, 3.6) SBP decrease (p = 0.159) and in PROP there was a 30.8-point (-45.6, -16.0) SBP decrease (p = 0.0002) with significant increases in heart rate (HR) and shock index (SI) (HR p = 0.001, SI p < 0.0001).
Conclusion:
In patients without hypotension prior to intubation, we observed a statistically significant drop in the patients' SBP with use of propofol. In trauma critical care unit patients, we recommend considering an induction medication for unplanned intubation other than propofol.
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