Background:

• Intubation of the critically ill may precipitate cardiac arrest
• Understanding predictors of which patients are likely to experience cardiac arrest may help ameliorate the risk

Study Design:

• Retrospective analysis of prospectively collected data on 1,847 intubations in 64 French ICUs

Patient Population:

• Critically ill patients in the ICU requiring intubation

Results:

• Summarized in the graphic below with Odds Ratios for cardiac arrest

Conclusions:

• Cardiac arrest resulted from nearly 1 in 40 intubation procedures

• Not surprisingly, pre-intubation hypotension, hypoxemia, and lack of preoxygenation were the strongest predictors of cardiac arrest

• Resuscitation of the patient before intubation along with a strong preoxygenation technique may help prevent cardiac arrest
• Check out this EM Daily article for some tips on preoxygenation: http://emdaily.cooperhealth.org/content/airway-mastery-series-got-oxygen-head-bed-preoxygenation-intubation

Source:

De Jong A, Rolle A, Molinari N et al. Cardiac Arrest and Mortality Related to Intubation Procedure in Critically Ill Adult Patients: A Multicenter Cohort Study. Critical Care Medicine 2017: epub ahead of print PMID: 29261566