دورية أكاديمية
Does the choice of induction agent in rapid sequence intubation in the emergency department influence the incidence of post-induction hypotension?
العنوان: | Does the choice of induction agent in rapid sequence intubation in the emergency department influence the incidence of post-induction hypotension? |
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المؤلفون: | Tamsett Z; Department of Emergency Medicine, Grampians Health, Ballarat, Victoria, Australia., Douglas N; Department of Anaesthesia, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia., King C; Department of Emergency Medicine, Grampians Health, Ballarat, Victoria, Australia.; School of Medicine, Deakin University, Geelong, Victoria, Australia., Johnston T; Department of Emergency Medicine, Grampians Health, Ballarat, Victoria, Australia., Bentley C; Department of Emergency Medicine, Grampians Health, Ballarat, Victoria, Australia., Hao B; Department of Emergency Medicine, Grampians Health, Ballarat, Victoria, Australia., Prinsloo D; Department of Emergency Medicine, Grampians Health, Ballarat, Victoria, Australia., Bourke EM; Department of Emergency Medicine, Grampians Health, Ballarat, Victoria, Australia.; Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia.; Department of Emergency Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia. |
المصدر: | Emergency medicine Australasia : EMA [Emerg Med Australas] 2024 Jun; Vol. 36 (3), pp. 340-347. Date of Electronic Publication: 2023 Nov 29. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Blackwell Pub Country of Publication: Australia NLM ID: 101199824 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1742-6723 (Electronic) Linking ISSN: 17426723 NLM ISO Abbreviation: Emerg Med Australas Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Wes Melbourne, Victoria : Blackwell Pub., c2004- |
مواضيع طبية MeSH: | Emergency Service, Hospital*/statistics & numerical data , Hypotension*/epidemiology , Hypotension*/drug therapy , Hypotension*/etiology , Rapid Sequence Induction and Intubation*/methods , Ketamine*/therapeutic use , Propofol*/adverse effects , Propofol*/therapeutic use , Propofol*/administration & dosage, Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Adult ; Incidence ; Fentanyl/therapeutic use ; Intubation, Intratracheal/methods ; Australia/epidemiology |
مستخلص: | Objective: To describe the effects of different induction agents on the incidence of post-induction hypotension (PIH) and its associated interventions during rapid sequence intubation (RSI) in the ED. Methods: A single centre retrospective study of patients intubated between 2018 and 2021 was conducted in a regional Australian ED. The impact of induction agent choice, in addition to demographic and clinical factors on the incidence of PIH were determined using descriptive statistics and a multivariate analysis presented as adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Results: Ketamine and propofol, used either individually or in conjunction with fentanyl, were significantly associated with PIH (ketamine aOR 4.5, 95% CI 1.35-14.96; propofol aOR 4.88, 95% CI 1.46-16.29). Age >60 years was associated with a greater requirement for vasopressors (aOR 4.46, 95% CI 2.49-7.97) and a higher risk of mortality after RSI (aOR 4.2, 95% CI 1.87-9.40). Patients with a shock index >1.0 were significantly more likely to require vasopressors (aOR 5.13, 95% CI 2.35-11.2) and have a cardiac arrest within 15 min of RSI (aOR 3.56, 95% CI 1.07-11.8). Conclusions: Exposure to both propofol and ketamine is significantly associated with PIH after RSI, alongside age and shock index. PIH is likely multifactorial in nature, and this data supports the sympatholytic effect of induction agents as the underlying cause of PIH rather than the choice of agent itself. Further prospective work including a randomised controlled trial between induction agents is justified to further clarify this important clinical question. (© 2023 Australasian College for Emergency Medicine.) |
References: | Soar J, Nolan JP, Böttiger BW et al. European resuscitation council guidelines for resuscitation 2015: section 3. Adult advanced life support. Resuscitation 2015; 95: 100–147. Alkhouri H, Vassiliadis J, Murray M et al. Emergency airway management in Australian and New Zealand emergency departments: a multicentre descriptive study of 3710 emergency intubations. Emerg. Med. Australas. 2017; 29: 499–508. Mace SE. Challenges and advances in intubation: rapid sequence intubation. Emerg. Med. Clin. North Am. 2008; 26: 1043–1068. Phillips L, Orford N, Ragg M. Prospective observational study of emergent endotracheal intubation practice in the intensive care unit and emergency department of an Australian regional tertiary hospital. Emerg. Med. Australas. 2014; 26: 368–375. Groth CM, Acquisto NM, Khadem T. Current practices and safety of medication use during rapid sequence intubation. J. Crit. Care 2018; 45: 65–70. Smischney NJ, Kashyap R, Khanna AK et al. Risk factors for and prediction of post‐intubation hypotension in critically ill adults: a multicenter prospective cohort study. PLoS One 2020; 15: e0233852. Heffner AC, Swords D, Kline JA, Jones AE. The frequency and significance of postintubation hypotension during emergency airway management. J. Crit. Care 2012; 27: 417.e9–417.e13. Freeman J, Alkhouri H, Knipp R, Fogg T, Gillett M. Mapping haemodynamic changes with rapid sequence induction agents in the emergency department. Emerg. Med. Australas. 2022; 34: 237–243. Ferguson I, Alkhouri H, Fogg T, Aneman A. Ketamine use for rapid sequence intubation in Australian and New Zealand emergency departments from 2010 to 2015: a registry study. Emerg. Med. Australas. 2019; 31: 205–210. Baradari AG, Alipour A, Habibi MR, Rashidaei S, Emami ZA. A randomized clinical trial comparing hemodynamic responses to ketamine‐propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery. Arch. Med. Sci. 2017; 13: 1102–1110. Soleimani A, Heidari N, Habibi MR et al. Comparing hemodynamic responses to diazepam, propofol and etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery: a double‐blind, randomized clinical trial. Med. Arch. 2017; 71: 198–203. Ferguson I, Buttfield A, Burns B et al. Fentanyl versus placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department: the FAKT study—a randomized clinical trial. Acad. Emerg. Med. 2022; 29: 719–728. Südfeld S, Brechnitz S, Wagner JY et al. Post‐induction hypotension and early intraoperative hypotension associated with general anaesthesia. Br. J. Anaesth. 2017; 119: 57–64. Sessler DI, Bloomstone JA, Aronson S et al. Perioperative quality initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. Br. J. Anaesth. 2019; 122: 563–574. Jor O, Maca J, Koutna J et al. Hypotension after induction of general anesthesia: occurrence, risk factors, and therapy. A prospective multicentre observational study. J. Anesth. 2018; 32: 673–680. Chen B, Pang QY, An R, Liu HL. A systematic review of risk factors for postinduction hypotension in surgical patients undergoing general anesthesia. Eur. Rev. Med. Pharmacol. Sci. 2021; 25: 7044–7050. Saugel B, Bebert EJ, Briesenick L et al. Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: a prospective observational study. J. Clin. Monit. Comput. 2022; 36: 341–347. Basagan‐Mogol E, Goren S, Korfali G, Turker G, Kaya FN. Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine. Clinics (Sao Paulo) 2010; 65: 133–138. Hoffman WE, Pelligrino D, Werner C, Kochs E, Albrecht RF, Schulte am Esch J. Ketamine decreases plasma catecholamines and improves outcome from incomplete cerebral ischemia in rats. Anesthesiology 1992; 76: 755–762. Driver BE, Trent SA, Prekker ME, Reardon RF, Brown CA 3rd. Sedative dose for rapid sequence intubation and postintubation hypotension: is there an association? Ann. Emerg. Med. 2023; 82: 417–424. Sjøen GH, Falk RS, Hauge TH, Tønnessen TI, Langesæter E. Hemodynamic effects of a low versus a high dose of propofol during induction of anesthesia. A randomized trial. Acta Anaesthesiol. Scand. 2023; 67: 1178–1186. Miller M, Kruit N, Heldreich C et al. Hemodynamic response after rapid sequence induction with ketamine in out‐of‐hospital patients at risk of shock as defined by the shock index. Ann. Emerg. Med. 2016; 68: 181–188.e2. Trivedi S, Demirci O, Arteaga G, Kashyap R, Smischney NJ. Evaluation of preintubation shock index and modified shock index as predictors of postintubation hypotension and other short‐term outcomes. J. Crit. Care 2015; 30: 861–867. Smischney NJ, Demirci O, Ricter BD et al. Vasopressor use as a surrogate for post‐intubation hemodynamic instability is associated with in‐hospital and 90‐day mortality: a retrospective cohort study. BMC. Res. Notes 2015; 8: 445. 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. Crit. Care Med. 2018; 46: 532–539. Ouchi K, Jambaulikar GD, Hohmann S et al. Prognosis after emergency department intubation to inform shared decision‐making. J. Am. Geriatr. Soc. 2018; 66: 1377–1381. Olaussen A, Blackburn T, Mitra B, Fitzgerald M. Review article: shock index for prediction of critical bleeding post‐trauma: a systematic review. Emerg. Med. Australas. 2014; 26: 223–228. Kurt E, Bahadirli S. The usefulness of shock index and modified shock index in predicting the outcome of COVID‐19 patients. Disaster Med. Public Health Prep. 2022; 16: 1558–1563. Strøm C, Rasmussen LS, Sieber FE. Should general anaesthesia be avoided in the elderly? Anaesthesia 2014; 69: 35–44. Van Dijck CP, Vanelderen P, Van Boxstael S. Ketamine for emergency endotracheal intubation: insights into post‐induction hemodynamic instability. Intensive Care Med. 2022; 48: 778. |
فهرسة مساهمة: | Keywords: anaesthetic morbidity; induction agents; post‐induction hypotension; rapid sequence intubation |
تواريخ الأحداث: | Date Created: 20231129 Date Completed: 20240519 Latest Revision: 20240519 |
رمز التحديث: | 20240520 |
DOI: | 10.1111/1742-6723.14355 |
PMID: | 38018391 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1742-6723 |
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DOI: | 10.1111/1742-6723.14355 |