Predicting Cardiovascular Collapse in Critically Ill Patients During Intubation Induction: A Prospective...

Area of Science:

• Critical Care Medicine
• Cardiovascular Physiology
• Anesthesiology

Background:

• Peri-Intubation Cardiovascular Collapse (PIC) is a critical complication during intensive care unit (ICU) intubations.
• Predictive markers for PIC are crucial for improving patient outcomes and guiding clinical decisions.
• Existing indices and induction agents require further evaluation for their role in predicting PIC.

Purpose of the Study:

• To assess the predictive value of various Shock Indices (SI, DSI, MSI, Age-SI) for PIC.
• To determine the influence of induction agents (ketamine, propofol) on PIC risk.
• To identify independent risk factors associated with PIC development in ICU patients.

Main Methods:

• A cohort of 130 ICU patients undergoing intubation was analyzed.
• Patients were categorized into PIC and Non-PIC groups based on predefined hemodynamic criteria.
• The predictive performance of Age Shock Index (Age-SI), Diastolic Shock Index (DSI), and induction agents was evaluated using logistic regression and AUC analysis.

Main Results:

• PIC occurred in 47.7% of patients.
• Age-SI demonstrated the highest predictive accuracy (AUC = 0.686).
• Ketamine was associated with a reduced risk of PIC (OR = 0.161), while propofol (OR = 2.962), age, lactate, and DSI were identified as independent risk factors.

Conclusions:

• Age, lactate, DSI, and Age-SI are significant predictors of PIC.
• Ketamine use is linked to a lower incidence of PIC, whereas propofol is associated with an increased risk.
• Findings support the integration of Age-SI and careful selection of induction agents into ICU intubation protocols for enhanced risk stratification.