A Systematic Echography During Intubation Procedure to Predict Cardiovascular Collapse

University Hospital, Brest70 enrolled

Overview

In the operating room, most intubation procedures (IP) are scheduled and performed on hemodynamically stable patients. In the ICU, IP is frequently performed in emergent patients, because of unstable hemodynamics and/or acute respiratory failure, and complicated by a subsequent cardiovascular collapse. Transthoracic echocardiography (TTE) has become readily available in most ICUs for several years. Echocardiography enables to perform a noninvasive hemodynamic evaluation (cardiac function and volemia status). We hypothesized that performing a TTE prior to IP may help to predict cardiovascular collapse and its components.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Intubation

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Patient requiring endotracheal intubation Exclusion Criteria: * Age \< 18 yrs * Pregnancy * Amputation of a lower limb * Passing leg raising contraindication: intracranial hypertension with invasive monitoring, fracture of the pelvis or limbs * Patients under administrative protective measures * Severe cardiovascular collapse before intubation * Severe cardiogenic pulmonary oedema

Locations (3)

Hôpital d'Instruction des Armées Clermont Tonnerre

Outcomes

Primary Outcomes

Subsequent cardiovascular collapse related to intubation

Mean arterial pressure drop \< 60 mmHg

Time frame: Within 15 minutes of intubation

Secondary Outcomes

Ultrasound parameters to predict fluid responsiveness

Transthoracic echocardiography parameters to predict fluid responsiveness

Time frame: 30 minutes before intubation, less than 30 minutes after intubation, 1 minutes after lifting legs and 3 hours after intubation