Postintubation Hypotension and its Association with Prolonged ICU Length of Stay and ICU Mortality

Introduction: Cardiovascular collapse (CVC) is a serious complication of endotracheal intubation (ETI). Many studies have evaluated incidence and risk factors for postintubation hypotension. In this study, we considered postintubation CVC as systolic blood pressure <65 mm Hg recorded at least once and/or <90 mm Hg for >= 30 minutes or the requirement of vasopressors and/or inotropes. The aim of this study is to assess the incidence and potential risk factor for severe CVC after ETI and its impact on intensive care unit (ICU) length of stay and mortality. Materials and Methods: This is a prospective cohort study that was conducted on 300 patients who were classified into two categories: those who were hemodynamicaly stable after intubation and those who colapsed. Different variables were documented in both groups and compared with the incidence of postintubation CVC. ICU length of stay and 28-day mortally were assessed in both groups. Results: 26.3% of subjects have developed CVC after ETI. Factors that were associated with increased incidence of CVC include old age, heart failure, chronic kidney disease, COPD, higher heart rate before and during intubation, and propofol usage for intubation. Postintubation CVC had a statistically significant association with prolonged ICU length of stay and increased ICU mortality. Conclusion: Postintubation CVC is associated with poorer outcomes with regard to ICU length of stay and ICU mortality. There are potential risk factors that need further evaluation to predict and/or decrease the incidence of CVC after ETI.