Incidence of and risk factors for postintubation hypotension in critically ill patients with COVID-19 Incidência e fatores de risco para hipotensão pós-intubação em pacientes críticos com COVID-19
Critical Care Science, cilt.34, sa.1, ss.131-140, 2022 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 34 Sayı: 1
- Basım Tarihi: 2022
- Doi Numarası: 10.5935/0103-507x.20220007-en
- Dergi Adı: Critical Care Science
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.131-140
- Anahtar Kelimeler: Coronavirus infections, COVID-19, Critical illness, Hospital mortality, Hypotension, Intensive care units, Intubation, intratracheal, Risk factors, SARS-CoV-2
- Süleyman Demirel Üniversitesi Adresli: Evet
Özet
Objective: To evaluate the incidence of risk factors for postintubation hypotension in critically ill patients with COVID-19. Met hods: We c onduc t e d 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 pati ents (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 l evel s < 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 associ ated wi th posti ntubati on 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.