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Original Article
Incidence of and risk factors for postintubation hypotension in critically ill patients with COVID-19
Rev Bras Ter Intensiva. 2022;34(1):131-140
Abstract
Original ArticleIncidence of and risk factors for postintubation hypotension in critically ill patients with COVID-19
Rev Bras Ter Intensiva. 2022;34(1):131-140
DOI 10.5935/0103-507X.20220007-en
Views2ABSTRACT
Objective:
To evaluate the incidence of risk factors for postintubation hypotension in critically ill patients with COVID-19.
Methods:
We conducted a retrospective study of 141 patients with COVID-19 who were intubated in the intensive care unit. Postintubation hypotension was defined as the need for any vasopressor dose at any time within the 60 minutes following intubation. Patients with intubation-related cardiac arrest and hypotension before intubation were excluded from the study.
Results:
Of the 141 included patients, 53 patients (37.5%) had postintubation hypotension, and 43.6% of the patients (n = 17) were female. The median age of the postintubation hypotension group was 75.0 (interquartile range: 67.0 – 84.0). In the multivariate analysis, shock index ≥ 0.90 (OR = 7.76; 95%CI 3.14 – 19.21; p < 0.001), albumin levels < 2.92g/dL (OR = 3.65; 95%CI 1.49 - 8.96; p = 0.005), and procalcitonin levels (OR = 1.07, 95%CI 1.01 - 1.15; p = 0.045) were independent risk factors for postintubation hypotension. Hospital mortality was similar in patients with postintubation hypotension and patients without postintubation hypotension (92.5% versus 85.2%; p = 0.29).
Conclusion:
The incidence of postintubation hypotension was 37.5% in critically ill COVID-19 patients. A shock index ≥ 0.90 and albumin levels < 2.92g/dL were independently associated with postintubation hypotension. Furthermore, a shock index ≥ 0.90 may be a practical tool to predict the increased risk of postintubation hypotension in bedside scenarios before endotracheal intubation. In this study, postintubation hypotension was not associated with increased hospital mortality in COVID-19 patients.
Keywords:Coronavirus infectionsCOVID-19Critical illnessHospital mortalityHypotensionIntensive care unitsintratrachealIntubationrisk factorsSARS-CoV-2See more
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis