Title: Postintubation Hypotension Matters
题目：插管后的低血压问题
Author 作者: Michael Winters

• It is clear that preintubation hypotension is associated with increased mortality in critically ill patients who require mechanical ventilation.
• 已经非常清楚的是，对于需要气管插管的危重病人，插管前低血压与死亡率增加有关。
• Unfortunatley, the literature is less clear on the frequency and impact of hypotension that develops after intubation.
• 不幸的是，对于插管后低血压的发生频率和作用并没有明确的报道。
• Two recent publications in the Journal of Intensive Care provide valuable information on postintubation hypotension. Some highlights of the studies include:
• 最新发表在美国‘危重病学杂志’上的两篇文章，对插管后的低血压提供了有价值的信息。其中要点列举如下：
◦ Retrospective cohorts of over 300 patients who developed postintubation hypotension, defined as a SBP < 90 mm Hg within 60 min of intubation.
◦ 这些回顾性研究包括插管后60分钟内发生低血压（收缩压低于90）的300余病人。
◦ Postintubation hypotension occurred in almost 25% of patients.
◦ 接近25％的病人出现插管后低血压。
◦ Median time to hypotension was 11 minutes.
◦ 平均低血压出现时间在11分钟。
◦ Patients with postintubation hypotension had a higher inhospital mortality(33% vs. 23%).
◦ 有插管后低血压的病人有较高的住院期间死亡率（33％与23％）。
◦ A preintubationShock Index > 0.8 was the strongest predictor of cardiovascular collapse after intubation.
◦ 插管前休克指数大于0.8是预测发生插管后心血管衰竭的最有效指标。
• Take Home Point: Postintubation hypotension occurs frequently and may be associated with worse outcomes.
• 要点：气管插管后低血压非常常见，并与恶性后果有关。

References参考文献

Heffner AC, Swords D, Kline JA, et al. The frequency and significance of postintubation hypotension during emergency airway management. J Crit Care 2012; 27:417e9-417e13.
Heffner AC, Swords D, Nussbaum ML, et al. Predictors of the complication of postintubation hypotension during emergency airway management. J Crit Care 2012; 27:587-593.