Preventing Cardiovascular Collapse With Administration of Fluid Resuscitation During Induction and Intubation

• Status: Completed
• Trial end date: 2021-06-21
• Target enrollment: 0
• Participant gender: All

Summary

Complications are common during tracheal intubation of critically ill patients. Nearly one in five patients undergoing intubation in the intensive care unit experiences cardiovascular collapse, defined as severe hypotension, vasopressor administration, cardiac arrest or death. Cardiovascular collapse during intubation is associated with increased resource utilization and decreased survival. Administration of 500 mL of intravenous crystalloid solution beginning prior to induction may prevent cardiovascular collapse. The only prior trial examining fluid bolus administration during intubation found no effect on cardiovascular collapse or clinical outcomes overall, but a hypothesis-generating subgroup analysis suggested potential benefit to fluid bolus administration among patients receiving positive pressure ventilation between induction and laryngoscopy. Therefore, we propose a randomized trial comparing fluid bolus administration versus none with regard to cardiovascular collapse among critically adults undergoing intubation with positive pressure ventilation between induction and laryngoscopy.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Vanderbilt University Medical Center

Criteria

Inclusion Criteria:

1. Patient is undergoing endotracheal intubation in a participating unit

2. Planned operator is a provider expected to routinely perform endotracheal intubation in the participating unit

3. Patient is at least 18 years of age

4. Administration of sedation is planned (with or without neuromuscular blockade)

5. Positive pressure ventilation between induction and laryngoscopy is planned (e.g., non-invasive ventilation or bag-mask ventilation)

Exclusion Criteria:

1. Prisoners

2. Pregnant patients

3. Urgency of intubation precludes safe performance of study procedures

4. Operator feels administration of a fluid bolus is indicated or contraindicated for the safe performance of the procedure