Department of Emergency Medicine, Myongi Hospital, Gyeonggi, South Korea.
Department of Emergency Medicine, Myongi Hospital, Gyeonggi, South Korea.
Am J Emerg Med. 2020 May;38(5):911-915. doi: 10.1016/j.ajem.2019.07.011. Epub 2019 Jul 8.
Hypotension after emergent ETI is a relatively common complication during and after emergency airway management. We aimed to evaluate SI, MSI, and age SI to predict PIH in patients who presented to the emergency department. Moreover, which factors would be better for predicting the event or similar to the others.
A retrospective, standardized chart review of consecutive ED patients requiring intubation at an urban, tertiary-care teaching hospital, from January 2011 to December 2016. PIH was defined as any recorded SBP <90 mmHg or MAP <65 mmHg within the 60-minute period after intubation.
Hypotension after emergent ETI was observed in 130 (29.7%) patients. The ROC-AUC of age SI, MSI, and SI before intubation for prediction of PIH were 0.676 (95% CI 0.63-0.72), 0.614 (95% CI 0.567-0.66), and 0.611 (95% CI 0.564-0.657). The prognostic performance of age SI for prediction of PIH was better than MSI and SI (p = 0.006 for age SI versus MSI, p = 0.005 for age SI versus SI).
Preintubation age SI, MSI, and SI are all independent predictors of PIH in patients who need emergent intubation. Aong these parameters, age SI is the best marker to predict the outcome. Calculation of these indexes are simple and could be an guide of implement to prevent hypotension after ETI.
在紧急气道管理期间和之后，紧急气管插管后出现低血压是一种相对常见的并发症。我们旨在评估 SI、MSI 和年龄 SI，以预测急诊科就诊患者发生 PIH。此外，哪些因素更适合预测该事件或与其他因素相似。
对 2011 年 1 月至 2016 年 12 月期间在城市三级教学医院需要插管的连续 ED 患者进行回顾性、标准化图表回顾。PIH 定义为插管后 60 分钟内任何记录的 SBP<90mmHg 或 MAP<65mmHg。
130 例（29.7%）患者出现紧急 ETI 后低血压。年龄 SI、MSI 和插管前 SI 预测 PIH 的 ROC-AUC 分别为 0.676（95%CI 0.63-0.72）、0.614（95%CI 0.567-0.66）和 0.611（95%CI 0.564-0.657）。年龄 SI 对 PIH 的预测预后优于 MSI 和 SI（年龄 SI 与 MSI 相比，p=0.006；年龄 SI 与 SI 相比，p=0.005）。
需紧急插管的患者插管前的年龄 SI、MSI 和 SI 均为 PIH 的独立预测因子。在这些参数中，年龄 SI 是预测结果的最佳标志物。计算这些指标很简单，可以作为预防 ETI 后低血压的实施指南。
