From the Research
The Russotto et al. study published in JAMA in 2021 is not directly referenced in the provided evidence, and therefore, its findings cannot be directly reported. Key findings from the available evidence:
- Peri-intubation cardiovascular instability/collapse occurred in 43.4% of patients undergoing tracheal intubation in a critically ill population, as reported in the INTUBE study 1
- The use of propofol as an induction agent was identified as a modifiable intervention significantly associated with cardiovascular instability/collapse 1
- Patients with peri-intubation cardiovascular instability/collapse were at a higher risk of ICU mortality, with an adjusted odds ratio of 2.47 (95% CI, 1.72-3.55) 1 Recommendations based on the available evidence:
- Routine use of propofol as an induction agent should be avoided in critically ill patients undergoing tracheal intubation, due to its association with cardiovascular instability/collapse
- Standard care, including close monitoring and optimization of hemodynamics, should be continued for these patients
- The use of videolaryngoscopy may be considered to facilitate tracheal intubation and reduce the risk of complications, as suggested by the findings of the INTUBE study and other research 2 The lack of direct evidence on the Russotto et al. study may be due to:
- The study not being included in the provided evidence
- The study being published in a different journal or year than reported
- The study not being relevant to the topic of tracheal intubation in critically ill patients While the available evidence focuses on tracheal intubation in critically ill patients, the findings may have implications for airway management in other patient populations, such as those with acute respiratory failure. However, the specific recommendations and guidelines may vary depending on the patient population and clinical context.