PDF(Pubmed)
Abstract：
UNASSIGNED: Postintubation hypotension (PIH) is a recognized complication that increases both in-hospital mortality and hospital length of stay. Sepsis is reportedly a factor associated with PIH. However, no study to date has examined which factors, including the intubation method, may be clinical predictors of PIH in patients with sepsis. This study aims to investigate factors associated with the occurrence of PIH in patients with suspected sepsis in emergency department.
UNASSIGNED: This retrospective cross-sectional study was performed over a 5-year period (January 2013-December 2017) and involved patients with suspected sepsis who underwent endotracheal intubation in the emergency department of Ramathibodi Hospital. The patients were divided into those with and without PIH, and factors associated with the occurrence of PIH were analyzed. PIH was defined as any recorded systolic blood pressure of <90 mmHg within 60 minutes of intubation.
UNASSIGNED: In total, 394 patients with suspected sepsis were included. PIH occurred in 106 patients (26.9%) and was associated with increased in-hospital mortality (43.00% in the PIH group vs 31.25% in the non-PIH group, P = 0.034). Multivariable logistic regression showed that the factors associated with PIH were an age of ≥61 years (adjusted odds ratio [aOR] 2.25; 95% confidence interval [CI] 1.14-4.43; P = 0.019) and initial serum lactate concentration of >4.4 mmol/L (aOR 2.00; 95% CI 1.16-3.46; P = 0.013). Rapid sequence intubation and difference types of induction agents was unrelated to PIH.
UNASSIGNED: Monitoring the development of PIH in patients with sepsis is essential because of its correlation with higher in-hospital mortality. This is particularly critical for older individuals and those with severe infections and high initial lactate concentrations.
UNASSIGNED: This retrospective cross-sectional study was performed over a 5-year period (January 2013-December 2017) and involved patients with suspected sepsis who underwent endotracheal intubation in the emergency department of Ramathibodi Hospital. The patients were divided into those with and without PIH, and factors associated with the occurrence of PIH were analyzed. PIH was defined as any recorded systolic blood pressure of <90 mmHg within 60 minutes of intubation.
UNASSIGNED: In total, 394 patients with suspected sepsis were included. PIH occurred in 106 patients (26.9%) and was associated with increased in-hospital mortality (43.00% in the PIH group vs 31.25% in the non-PIH group, P = 0.034). Multivariable logistic regression showed that the factors associated with PIH were an age of ≥61 years (adjusted odds ratio [aOR] 2.25; 95% confidence interval [CI] 1.14-4.43; P = 0.019) and initial serum lactate concentration of >4.4 mmol/L (aOR 2.00; 95% CI 1.16-3.46; P = 0.013). Rapid sequence intubation and difference types of induction agents was unrelated to PIH.
UNASSIGNED: Monitoring the development of PIH in patients with sepsis is essential because of its correlation with higher in-hospital mortality. This is particularly critical for older individuals and those with severe infections and high initial lactate concentrations.
摘要：
■插管后低血压（PIH）是一种公认的并发症，可增加住院死亡率和住院时间。据报道,脓毒症是与PIH相关的因素。然而,到目前为止，还没有研究检查哪些因素，包括插管法,可能是脓毒症患者PIH的临床预测因子。本研究旨在探讨急诊疑似脓毒症患者发生PIH的相关因素。
这项回顾性横断面研究历时5年（2013年1月至2017年12月），纳入了在Ramathibodi医院急诊科接受气管插管的疑似脓毒症患者。患者分为有和无PIH,分析与PIH发生相关的因素。PIH定义为插管60分钟内任何记录的收缩压<90mmHg。
■总共，纳入394例疑似脓毒症患者。106例患者（26.9%）发生PIH，与住院死亡率增加相关（PIH组为43.00%，非PIH组为31.25%，P=0.034)。多变量logistic回归分析显示，与PIH相关的因素是年龄≥61岁（校正比值比[aOR]2.25;95％置信区间[CI]1.14-4.43;P=0.019）和初始血清乳酸浓度>4.4mmol/L（aOR2.00;95％CI1.16-3.46;P=0.013）。快速顺序插管和不同类型的诱导剂与PIH无关。
■监测脓毒症患者PIH的发展至关重要，因为它与较高的住院死亡率相关。这对于老年人和患有严重感染和高初始乳酸浓度的人尤其重要。
这项回顾性横断面研究历时5年（2013年1月至2017年12月），纳入了在Ramathibodi医院急诊科接受气管插管的疑似脓毒症患者。患者分为有和无PIH,分析与PIH发生相关的因素。PIH定义为插管60分钟内任何记录的收缩压<90mmHg。
■总共，纳入394例疑似脓毒症患者。106例患者（26.9%）发生PIH，与住院死亡率增加相关（PIH组为43.00%，非PIH组为31.25%，P=0.034)。多变量logistic回归分析显示，与PIH相关的因素是年龄≥61岁（校正比值比[aOR]2.25;95％置信区间[CI]1.14-4.43;P=0.019）和初始血清乳酸浓度>4.4mmol/L（aOR2.00;95％CI1.16-3.46;P=0.013）。快速顺序插管和不同类型的诱导剂与PIH无关。
■监测脓毒症患者PIH的发展至关重要，因为它与较高的住院死亡率相关。这对于老年人和患有严重感染和高初始乳酸浓度的人尤其重要。
