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Focus On Hemodynamics in the Peri-Intubation Period

EVIDENCE based airway

When it comes to intubation we are often focused on oxygenation and ventilation, but recent evidence tells us we should also be paying more attention to hemodynamics. Check out the paper and the review below. Then check out our learning space on the physiologically difficult airway.

Paper: Russotto V et al. Intubation Practices and adverse Peri-Intubation Events in Critically Ill Patients From 29 Countries. JAMA 2021. PMID: 33755076 [Access on Read by QxMD]

Author Conclusion: “In this observational study of intubation practices in critically ill patients from a convenience sample of 197 sites across 29 countries, major adverse peri-intubation events – in particular cardiovascular instability – were observed frequently.”

Great FOAM Review by REBELEM

Clinical Take Home Point: In critically ill patients from 197 sites across 29 countries, major adverse peri-intubation events occurred frequently. In particular cardiovascular instability was very common.  RESUSCITATE BEFORE YOU INTUBATE. Strategies to consider in reducing cardiovascular instability prior to intubation include: IV fluids where appropriate, peripheral pressors (push-dose and/or drips), dosing sedatives low/paralytics high, and consideration for awake intubation.

Bottom Line

Hemodynamics in the peri-intubation period are a critical component of airway management. Learn more here.

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Resuscitate before you intubate! Okay… but how? This learning space is where the rubber meets the road.