Peri-intubation Cardiovascular Collapse During Emergency Airway Management.

Area of Science:

• Critical Care Medicine
• Anesthesiology
• Emergency Medicine

Background:

• Emergency airway management is vital but carries risks like hypotension, linked to poor outcomes.
• Peri-intubation hypotension affects over 40% of cases, highlighting a critical knowledge gap.
• Current guidelines lack specific strategies for hemodynamic optimization before intubation.

Purpose of the Study:

• To synthesize current knowledge on peri-intubation hemodynamic deterioration.
• To review evidence-based strategies for hemodynamic optimization before emergency airway management.
• To provide a framework for mitigating cardiovascular collapse during rapid sequence intubation.

Main Methods:

• Comprehensive literature review on peri-intubation hypotension.
• Analysis of risk factors, pathophysiology, and epidemiological data.
• Synthesis of targeted optimization strategies including fluid resuscitation, vasopressors, and advanced monitoring.

Main Results:

• Peri-intubation hypotension is common and associated with significant morbidity and mortality.
• Strategies for optimization include fluid resuscitation, vasopressor use, and advanced preoxygenation.
• Extracorporeal membrane oxygenation may serve as adjunctive therapy in high-risk patients.

Conclusions:

• Effective hemodynamic optimization is crucial for safe emergency airway management.
• Further research is needed to establish evidence-based protocols for preventing peri-intubation cardiovascular collapse.
• This review offers a framework to guide clinicians in managing high-risk airway scenarios.