Review
The Relationship between Intubation and Collapse: Tips for Safe Intubation in the Critically Patient
Abstract
Tracheal intubation is among the most frequently performed procedures in critically ill patients. Different variables have been identified that increase the risk of major complications of tracheal intubation. Intubation-related cardiac arrest and intubation-related hypotension are the major complications reported in tracheal intubations performed in critically ill patients. In the light of the current literature, hypotension before endotracheal intubation is the most important risk factor for intubation-related vascular collapse. There is not enough literature yet to recommend bolus fluid or inotropic administration, and current studies have many limitations. Clinicians and researchers should be encouraged to do more research in this area.
References
- Özkan A. Diagnostic accuracy of clinical gestalt of doctors with different experiences in COVID-19 suspected patients. Journal of Experimental and Clinical Medicine. 2022; 39(3): 738-742. doi: 10.52142/omujecm.39.3.28.
- Taş G, Algın A, Özdemir S, Erdoğan M. Prospective observational study of the endotracheal ıntubation complications in emergency department. J Exp Clin Med. 2021; 38(4): 678-681. doi: 10.52142/omujecm.38.4.48.
- Russotto V, Myatra SN, Laffey JG. What’s new in airway management of the critically ill. Intensive Care Med. 2019;45(11):1615-1618. doi: 10.1007/s00134-019-05757-0.
- Özdemir S, Altunok İ. Acil serviste endotrakeal entübasyon. Maltepe Tıp Dergisi 2022; 14(2): 47-48. doi: 10.35514/mtd.2022.70.
- Myatra SN, Divatia JV, Brewster DJ. The physiologically difficult airway: an emerging concept. Curr Opin Anaesthesiol. 2022;35(2):115-121. doi: 10.1097/ACO.0000000000001102.
- Funk DJ, Jacobsohn E, Kumar A. Role of the venous return in critical illness and shock: part II-shock and mechanical ventilation. Crit Care Med. 2013 Feb;41(2):573-579. doi: 10.1097/CCM.0b013e31827bfc25.
- Yurtseven A, Turan C, Kılınç MA, Ulaş Saz E. Frequency and outcomes of endotracheal intubation in the pediatric emergency department. Turk J Pediatr. 2017;59(5):524-530. doi: 10.24953/turkjped.2017.05.004.
- Kim WY, Kwak MK, Ko BS, Yoon JC, Sohn CH, Lim KS, et al. Factors associated with the occurrence of cardiac arrest after emergency tracheal intubation in the emergency department. PLoS One. 2014;9(11):e112779. doi: 10.1371/journal.pone.0112779.
- Green RS, Edwards J, Sabri E, Fergusson D. Evaluation of the incidence, risk factors, and impact on patient outcomes of postintubation hemodynamic instability. CJEM. 2012;14(2):74-82. doi: 10.2310/8000.2012.110548.
- Heffner AC, Swords DS, Nussbaum ML, Kline JA, Jones AE. Predictors of the complication of postintubation hypotension during emergency airway management. J Crit Care. 2012;27(6):587-593. doi: 10.1016/j.jcrc.2012.04.022.
- De Jong A, Rolle A, Molinari N, Paugam-Burtz C, Constantin JM, Lefrant JY, et al. Cardiac arrest and mortality related to ıntubation procedure in critically ill adult patients: A multicenter cohort study. Crit Care Med. 2018;46(4):532-539. doi: 10.1097/CCM.0000000000002925.
- Ergün B, Ergan B, Yakar MN, Küçük M, Özçelik M, Yaka E, et al. Incidence 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-pt.
- Janz DR, Casey JD, Semler MW, Russell DW, Dargin J, Vonderhaar DJ, et al; PrePARE Investigators; Pragmatic Critical Care Research Group. Effect of a fluid bolus on cardiovascular collapse among critically ill adults undergoing tracheal intubation (PrePARE): a randomised controlled trial. Lancet Respir Med. 2019;7(12):1039-1047. doi: 10.1016/S2213-2600(19)30246-2.
- Russell DW, Casey JD, Gibbs KW, Ghamande S, Dargin JM, Vonderhaar DJ, et al; PREPARE II investigators and the pragmatic critical care research group. Effect of fluid bolus administration on cardiovascular collapse among critically ill patients undergoing tracheal intubation: A randomized clinical trial. JAMA. 2022;328(3):270-279. doi: 10.1001/jama.2022.9792.
- Davis DP, Olvera D, Selde W, Wilmas J, Stuhlmiller D. Bolus Vasopressor Use for air medical rapid sequence intubation: The vasopressor intravenous push to enhance resuscitation trial. Air Med J. 2023;42(1):36-41. doi: 10.1016/j.amj.2022.09.004.
- https://www.clinicaltrials.gov/ct2/show/NCT05318066. 3 Mayıs 2023 tarihinde erişilmiştir.
Year 2023,
Volume: 5 Issue: 3, 136 - 138, 01.11.2023
Abstract
Trakeal entübasyon, kritik hastalarda en sık uygulanan işlemlerden biridir. Bu işlem sırasında, trakea (soluk borusu) içerisine bir tüp yerleştirilerek hastanın solunum fonksiyonu desteklenir. Ancak, trakeal entübasyonun beraberinde bazı majör komplikasyon riskleri bulunmaktadır. Özellikle entübasyon ilişkili kardiyak arrest ve entübasyon ilişkili hipotansiyon bu komplikasyonlardan bazılarıdır. Mevcut literatür, trakeal entübasyon öncesi hipotansiyonun entübasyon ilişkili vasküler kollaps için en önemli risk faktörü olduğunu göstermektedir. Ancak, bolus sıvı veya inotrop (kan basıncını artıran ilaçlar) uygulamalarının önerilmesi konusunda yeterli kanıt henüz bulunmamaktadır ve mevcut çalışmaların kısıtlamaları bulunmaktadır. Bu nedenle, klinisyenler ve araştırmacılar daha fazla çalışma yapmaya teşvik edilmelidir. Bu alanda daha fazla araştırma yapılması, trakeal entübasyonun komplikasyonlarının önlenmesi ve daha iyi sonuçların elde edilmesi için önemlidir.
References
- Özkan A. Diagnostic accuracy of clinical gestalt of doctors with different experiences in COVID-19 suspected patients. Journal of Experimental and Clinical Medicine. 2022; 39(3): 738-742. doi: 10.52142/omujecm.39.3.28.
- Taş G, Algın A, Özdemir S, Erdoğan M. Prospective observational study of the endotracheal ıntubation complications in emergency department. J Exp Clin Med. 2021; 38(4): 678-681. doi: 10.52142/omujecm.38.4.48.
- Russotto V, Myatra SN, Laffey JG. What’s new in airway management of the critically ill. Intensive Care Med. 2019;45(11):1615-1618. doi: 10.1007/s00134-019-05757-0.
- Özdemir S, Altunok İ. Acil serviste endotrakeal entübasyon. Maltepe Tıp Dergisi 2022; 14(2): 47-48. doi: 10.35514/mtd.2022.70.
- Myatra SN, Divatia JV, Brewster DJ. The physiologically difficult airway: an emerging concept. Curr Opin Anaesthesiol. 2022;35(2):115-121. doi: 10.1097/ACO.0000000000001102.
- Funk DJ, Jacobsohn E, Kumar A. Role of the venous return in critical illness and shock: part II-shock and mechanical ventilation. Crit Care Med. 2013 Feb;41(2):573-579. doi: 10.1097/CCM.0b013e31827bfc25.
- Yurtseven A, Turan C, Kılınç MA, Ulaş Saz E. Frequency and outcomes of endotracheal intubation in the pediatric emergency department. Turk J Pediatr. 2017;59(5):524-530. doi: 10.24953/turkjped.2017.05.004.
- Kim WY, Kwak MK, Ko BS, Yoon JC, Sohn CH, Lim KS, et al. Factors associated with the occurrence of cardiac arrest after emergency tracheal intubation in the emergency department. PLoS One. 2014;9(11):e112779. doi: 10.1371/journal.pone.0112779.
- Green RS, Edwards J, Sabri E, Fergusson D. Evaluation of the incidence, risk factors, and impact on patient outcomes of postintubation hemodynamic instability. CJEM. 2012;14(2):74-82. doi: 10.2310/8000.2012.110548.
- Heffner AC, Swords DS, Nussbaum ML, Kline JA, Jones AE. Predictors of the complication of postintubation hypotension during emergency airway management. J Crit Care. 2012;27(6):587-593. doi: 10.1016/j.jcrc.2012.04.022.
- De Jong A, Rolle A, Molinari N, Paugam-Burtz C, Constantin JM, Lefrant JY, et al. Cardiac arrest and mortality related to ıntubation procedure in critically ill adult patients: A multicenter cohort study. Crit Care Med. 2018;46(4):532-539. doi: 10.1097/CCM.0000000000002925.
- Ergün B, Ergan B, Yakar MN, Küçük M, Özçelik M, Yaka E, et al. Incidence 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-pt.
- Janz DR, Casey JD, Semler MW, Russell DW, Dargin J, Vonderhaar DJ, et al; PrePARE Investigators; Pragmatic Critical Care Research Group. Effect of a fluid bolus on cardiovascular collapse among critically ill adults undergoing tracheal intubation (PrePARE): a randomised controlled trial. Lancet Respir Med. 2019;7(12):1039-1047. doi: 10.1016/S2213-2600(19)30246-2.
- Russell DW, Casey JD, Gibbs KW, Ghamande S, Dargin JM, Vonderhaar DJ, et al; PREPARE II investigators and the pragmatic critical care research group. Effect of fluid bolus administration on cardiovascular collapse among critically ill patients undergoing tracheal intubation: A randomized clinical trial. JAMA. 2022;328(3):270-279. doi: 10.1001/jama.2022.9792.
- Davis DP, Olvera D, Selde W, Wilmas J, Stuhlmiller D. Bolus Vasopressor Use for air medical rapid sequence intubation: The vasopressor intravenous push to enhance resuscitation trial. Air Med J. 2023;42(1):36-41. doi: 10.1016/j.amj.2022.09.004.
- https://www.clinicaltrials.gov/ct2/show/NCT05318066. 3 Mayıs 2023 tarihinde erişilmiştir.
There are 16 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Emergency Medicine |
| Journal Section | Review |
| Authors | |
| Early Pub Date | October 24, 2023 |
| Publication Date | November 1, 2023 |
| Submission Date | May 3, 2023 |
| Acceptance Date | July 11, 2023 |
| Published in Issue | Year 2023 Volume: 5 Issue: 3 |
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