Akademik Veri Yönetim Sistemi
Bratislava Medical Journal, 2025 (SCI-Expanded)
Objective: Post-intubation hypotension (PIH) is a common complication following rapid sequence intubation (RSI) in the emergency department (ED), potentially leading to adverse outcomes. Cerebral autoregulation typically maintains stable cerebral blood flow despite blood pressure fluctuations; however, its response in PIH remains unclear. This study aimed to evaluate the relationship between PIH and cerebral oxygenation using near-infrared spectroscopy (NIRS) in ED patients undergoing RSI. Methods: This prospective observational study included adult patients (≥ 18 years) who underwent RSI in a tertiary ED. Patients with pre-existing hypotension, cardiac arrest, or contraindications to NIRS monitoring were excluded. Cerebral oxygenation (rSO₂) was continuously monitored using the INVOS™ system for 10 min. PIH was defined as a systolic blood pressure < 90 mmHg, mean arterial pressure < 65 mmHg, or vasopressor initiation within 10 min post-intubation. A ≥ 20% decrease in rSO₂ from baseline was considered clinically significant. Results: A total of 51 patients were analyzed, with a mean age of 65 ± 19 years. PIH occurred in 13 patients (25.5%), while a ≥ 20% decrease in rSO₂ was observed in 8 patients. Only one patient with PIH exhibited a significant rSO₂ decline. No significant association was found between PIH and rSO₂ decline (p = 0.49). Conclusion: Although this study found no significant association between PIH and cerebral oxygenation changes measured via NIRS in ED patients undergoing RSI, the limited number of patients and the presence of multiple potential confounding factors may have influenced the results. According to the results of our study, although post-intubation hypotension is a concern, cerebral autoregulation likely plays a protective role in maintaining stable cerebral oxygenation in the majority of cases.