Predicting Cardiovascular Collapse in Critically Ill Patients During Intubation Induction: A Prospective Observational Study.
Ömer Emgin, Gamze Taşkan, Aytuğ Yıldız, İmren Taşkıran, Engin Haftacı, Adnan Ata, Mehmet Yılmaz
Medicina (Kaunas, Lithuania) January 15, 2026 DOI: 10.3390/medicina62010177 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 130 |
| Population | Intensive care unit patients undergoing intubation |
| Interventions | ketamine propofol |
| Topics | Ketamine |
| Keywords | Intensive care unit Peri-intubation cardiovascular collapse Propofol Shock indices |
| Key findings | Ketamine reduced the risk of peri-intubation cardiovascular collapse, while propofol, older age, higher lactate, and higher Diastolic Shock Index increased the risk. |
Abstract
Background and
Objectives: The study aimed to evaluate the predictive significance of Shock Indices and induction agents in predicting the risk of Peri-Intubation Cardiovascular Collapse (PIC) during intubation in the ICU.
Materials and Methods: A total of 130 patients were analyzed in the study after dividing them into 2 groups based on the definition of PIC as Patients with PIC and Non-PIC Patients. PIC was defined as the detection of at least SBP 90 mmHg with >15 mL/kg crystalloid fluid infusion, or development of cardiac arrest. The relationship between Shock Index (SI), Diastolic Shock Index (DSI), Modified Shock Index (MSI), Age Shock Index (Age-SI), and induction agents (ketamine, propofol) and PIC was evaluated.
Results: The PIC was detected in 62 patients (47.7%). Age-SI showed the highest predictive performance (AUC = 0.686, p < 0.001). Ketamine provided a protective effect (OR = 0.161, p = 0.003). Propofol (OR = 2.962, p = 0.048), age (OR = 1.065, p = 0.002), lactate (OR = 1.265, p = 0.047), and DSI (OR = 2.300, p = 0.037) were identified as independent risk factors. ICU mortality was significantly higher in the PIC group (74.2% vs. 20.6%, p < 0.001).
Conclusions: Age, lactate, DSI, and Age-SI are valuable predictive parameters for PIC. Ketamine reduces the risk of PIC, while propofol increases it. These results support evidence-based risk assessment and induction agent selection in ICU intubation protocols.
Comparable studies
Other observational and cohort studies on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Taming the Ketamine Tiger Volunteers from a prison population | 2010 | Observational study | n = 20 |
| Increased spontaneous MEG signal diversity for psychoactive doses of ketamine, LSD and psilocybin Humans | 2017 | Observational study | |
| Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane Surgical patients undergoing induction of anesthesia with intravenous ketamine | 2013 | Observational cohort | n = 30 |
| Do the dissociative side effects of ketamine mediate its antidepressant effects? Treatment-resistant inpatients with major depressive disorder or bipolar disorder | 2014 | Observational cohort | n = 108 |
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |