The impact of post-intubation hypotension on length of stay and mortality in adult and geriatric patients: a cohort study

Are outcomes worse in patients who develop post-intubation hypotension?

“…In this edition of CJEM, Émond et al [4] add to the literature on post-intubation hypotension by evaluating its impact on 48 h in-hospital mortality and hospital length of stay in a cohort of 586 adult and geriatric ED patients at a level 1 trauma center. The authors use 4 definitions to assess for development of post-intubation hypotension within 60 min of intubation: ≥ 1 systolic blood pressure (SBP) measure < 90 mmHg, ≥ 2 SBP measures < 90 mmHg, ≥ 1 SBP measure < 110 mmHg, or ≥ 2 SBP measures < 110 mmHg.…”

“…Variation in the reported effects of post-intubation hypotension on patient outcomes is likely attributable in part to differences in study populations and outcomes assessed. Perhaps more importantly, this variation also stems from how post-intubation hypotension is defined in each study, as highlighted by Émond and colleagues [4]. All published definitions agree on the concept of reduced blood pressure following intubation; however, they often differ in the period over which post-intubation hypotension is assessed, blood pressure cutoffs, degree of blood pressure decrease, and whether they incorporate any other considerations such as use of vasopressor medications or the existence of preintubation hypotension.…”

“…Although most literature points toward an association between post-intubation hypotension and poor outcomes, the study by Émond et al [4] is an important contribution to the body of evidence on this topic. More effort is needed to work toward a standardized, consensus definition that will facilitate further investigations.…”