{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:46:24Z","timestamp":1792183584654,"version":"4.4.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"University of Milano-Bicocca, Monza, Italy"},{"name":"University of Milano-Bicocca, Monza, Italy"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,8,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Cardiovascular instability\/collapse is a common peri-intubation event in patients who are critically ill.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify potentially modifiable variables associated with peri-intubation cardiovascular instability\/collapse (i.e., systolic arterial pressure &amp;lt;65 mm Hg [once] or &amp;lt;90 mm Hg for &amp;gt;30 minutes; new\/increased vasopressor requirement; fluid bolus &amp;gt;15 ml\/kg, or cardiac arrest).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>INTUBE (International Observational Study to Understand the Impact and Best Practices of Airway Management In Critically Ill Patients) was a multicenter prospective cohort study of patients who were critically ill and undergoing tracheal intubation in a convenience sample of 197 sites from 29 countries across five continents from October 1, 2018, to July 31, 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>A total of 2,760 patients were included in this analysis. Peri-intubation cardiovascular instability\/collapse occurred in 1,199 out of 2,760 patients (43.4%). Variables associated with this event were older age (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.02\u20131.03), higher heart rate (OR, 1.008; 95% CI, 1.004\u20131.012), lower systolic blood pressure (OR, 0.98; 95% CI, 0.98\u20130.99), lower oxygen saturation as measured by pulse oximetry\/Fi \u00a0O2 before induction (OR, 0.998; 95% CI, 0.997\u20130.999), and the use of propofol as an induction agent (OR, 1.28; 95% CI, 1.05\u20131.57). Patients with peri-intubation cardiovascular instability\/collapse were at a higher risk of ICU mortality with an adjusted OR of 2.47 (95% CI, 1.72\u20133.55), P\u2009&amp;lt;\u20090.001. The inverse probability of treatment weighting method identified the use of propofol as the only factor independently associated with cardiovascular instability\/collapse (OR, 1.23; 95% CI, 1.02\u20131.49). When administered before induction, vasopressors (OR, 1.33; 95% CI, 0.84\u20132.11) or fluid boluses (OR, 1.17; 95% CI, 0.96\u20131.44) did not reduce the incidence of cardiovascular instability\/collapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Peri-intubation cardiovascular instability\/collapse was associated with an increased risk of both ICU and 28-day mortality. The use of propofol for induction was identified as a modifiable intervention significantly associated with cardiovascular instability\/collapse.<\/jats:p>\n                    <jats:p>Clinical trial registered with clinicaltrials.gov (NCT03616054).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202111-2575oc","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T11:02:46Z","timestamp":1652180566000},"page":"449-458","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":154,"title":["Peri-intubation Cardiovascular Collapse in Patients Who Are Critically Ill: Insights from the INTUBE Study"],"prefix":"10.1093","volume":"206","author":[{"given":"Vincenzo","family":"Russotto","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Critical Care, University Hospital San Luigi Gonzaga, University of Turin, 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