الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cardiovascular collapse (CVC) is a serious complication of endotracheal intubation (ETI). from a physiological point of view, it could be attributed to the changes that occur in venous return, intrathoracic pressure, PaCO2 and catecholamine level. The incidence of postintubation CVC varies among different studies. In our study, it was 26.3% among intubated patients who were hemodynamically stable before intubation. There is no universally agreed definition of postintubation cardiovascular collapse. In this study, we considered severe (CVC) as systolic blood pressure ≤65 mmHg recorded at least once and/or ≤90 mmHg for ≥30 minutes or the requirement of vasopressors and/or inotropes.
This is an observational prospective cohort study that was conducted on 300 patients in six ICUs which are affiliated to critical care medicine department in Alexandria main university hospital. The aim of this study was to assess the incidence and potential risk factor for severe CVC after ETI and its impact on ICU length of stay and ICU mortality. Subjects were classified into two categories: those who were hemodynamically stable after intubation and those who collapsed. Different variables were documented including: demographic data, cause of admission, reason for intubation, past medical history, social history, characteristics of intubation, methods of preoxygenation, induction drugs, blood pressure and heart rate. All these parameters were correlated with incidence of postintubation CVC to detect any statistically significant relationship. Then the impact of postintubation CVC on the ICU length of stay and 28-day mortality was assessed.
Factors that were associated with increased incidence of CVC include: old age, heart failure, hypertension, CKD, COPD, higher heart rate before and during intubation, lower systolic blood pressure before and during intubation and propofol usage for intubation. We concluded the presence of statistically significant relation between the incidence of postintubation CVC and both ICU length of stay and 28-days mortality. The mean value for ICU length of stay for collapsed patients was 15.08 ± 8.51 days whereas it was 10.97 ± 9.60 days for non-collapsed patients (P < 0.001). 67.2% of collapsed patients have died within 28 days of intubation while only 27.1% of non-collapsed patients have died within the same period (P < 0.001