Anaesthetic Complication Cardiac, Cardiovascular Collapse, Intubation Complication
Conditions
Keywords
cardiac arrest, intubation, shock index
Brief summary
This prospective observational study evaluates the impact of propofol and ketamine on the risk of cardiovascular collapse during induction for endotracheal intubation in critically ill patients. Induction agents play a crucial role in managing hemodynamic stability, particularly in this vulnerable population. Propofol, known for its vasodilatory and myocardial depressant effects, has been associated with significant hypotension during induction. Conversely, ketamine, with its sympathomimetic properties, is often considered a safer alternative for hemodynamic stability. In addition to comparing the incidence of cardiovascular collapse-defined as severe hypotension or cardiac arrest-this study examines the relationship between these induction agents and shock indices, including systolic shock index, diastolic shock index, age-adjusted shock index, and modified shock index. These parameters will provide a more detailed understanding of the hemodynamic effects of each agent and their clinical implications. The findings aim to guide induction agent selection to optimize outcomes in critically ill patients.
Interventions
OTHERpropofol
The hemodynamic effects of propofol and ketamine are well-documented in the general patient population, yet the incidence and characteristics of cardiovascular collapse induced by these agents in critically ill patients remain underexplored. Cardiovascular collapse, a severe and potentially life-threatening event, may arise due to the unique physiological stressors present in the critical care setting, including pre-existing hemodynamic instability, comorbidities, and the administration of high-risk pharmacological agents. Despite the theoretical understanding of these drugs' pharmacodynamics, there is limited evidence assessing their differential impact on cardiovascular function in this vulnerable population. This study aims to contribute novel insights to the literature by exploring the association between these widely used sedative-hypnotic agents and the development of cardiovascular collapse. While propofol is known for its potent vasodilatory and myocardial depressive effects,
OTHERketamine
The hemodynamic effects of propofol and ketamine are well-documented in the general patient population, yet the incidence and characteristics of cardiovascular collapse induced by these agents in critically ill patients remain underexplored. Cardiovascular collapse, a severe and potentially life-threatening event, may arise due to the unique physiological stressors present in the critical care setting, including pre-existing hemodynamic instability, comorbidities, and the administration of high-risk pharmacological agents. Despite the theoretical understanding of these drugs' pharmacodynamics, there is limited evidence assessing their differential impact on cardiovascular function in this vulnerable population. This study aims to contribute novel insights to the literature by exploring the association between these widely used sedative-hypnotic agents and the development of cardiovascular collapse. While propofol is known for its potent vasodilatory and myocardial depressive effects,
Sponsors
Kocaeli City Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged over 18 years * Patients admitted to the intensive care unit (ICU) who undergo endotracheal intubation during their ICU stay will be included.
Exclusion criteria
* Patients who did not provide consent to participate in the study * Patients intubated due to cardiac arrest * Patients intubated outside the intensive care unit
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| cardiovascular collapse | The occurrence of any of the above-mentioned events within the first 30 minutes following the initiation of the intervention will be considered as cardiovascular collapse. | * At least one documented episode of SpO₂ \< 80%, ensuring accuracy of measurement. * At least one episode of systolic arterial blood pressure (SAB) \< 65 mmHg. * SAB \< 90 mmHg sustained for a duration of 30 minutes. * Initiation of norepinephrine therapy. * Escalation of pre-existing norepinephrine infusion dose. * Administration of \>15 mL/kg crystalloid fluids to achieve SAB \> 90 mmHg. * Occurrence of cardiac arrest. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactÖmer Emgin, MD
Outcome results
None listed