Table 3. Outcomes of Tracheal Intubation.
| Fluid bolus (n = 538) | No fluid bolus (n = 527) | Difference (95% CI)a | |
|---|---|---|---|
| Primary outcome | |||
| Cardiovascular collapse, No. (%)b | 113 (21.0) | 96 (18.2) | Absolute, 2.8 (−2.2 to 7.7) |
| New or increased receipt of vasopressors | 111 (20.6) | 93 (17.6) | Absolute, 3.0 (−1.9 to 7.9) |
| Systolic blood pressure <65 mm Hgc | (n = 535) 21 (3.9) |
(n = 524) 22 (4.2) |
Absolute, −0.3 (−2.8 to 2.3) |
| Cardiac arrest | 9 (1.7) | 8 (1.5) | Absolute, 0.2 (−1.5 to 1.8) |
| Death | 4 (0.7) | 3 (0.6) | Absolute, 0.2 (−1.0 to 1.3) |
| Secondary outcome | |||
| In-hospital death prior to 28 d, No. (%) | 218 (40.5) | 223 (42.3) | Absolute, −1.8 (−7.9 to 4.3) |
| Exploratory procedural outcomes d | |||
| Systolic blood pressure, median (IQR), mm Hgc | |||
| Lowest level | 116 (93 to 139) | 113 (95 to 134) | Median, 3.0 (−3.0 to 7.0) |
| Change in level | −7 (−26 to 0) | −9 (−27 to 0) | Median, 2.0 (−2.0 to 5.0) |
| Lowest arterial oxygen saturation, median (IQR), mm Hg | 96 (86 to 100) | 96 (88 to 100) | Median, 0 (−2.0 to 1.0) |
| Oxygen saturation <80%, No. (%) | (n = 531) 79 (14.9) |
(n = 518) 71 (13.7) |
Absolute, 1.2 (−3.3 to 5.6) |
| Exploratory clinical outcomes, median (IQR) | |||
| Invasive mechanical ventilation–free days through 28 de | 14 (0 to 25) | 12 (0 to 25) | Median, 2.0 (−10.0 to 15.0) |
| Intensive care unit–free days through 28 df | 9 (0 to 22) | 9 (0 to 22) | Median, −0.5 (−9.0 to 9.5) |
The absolute differences are expressed as percentages.
The between-group difference was not statistically significant (P = .25 with χ2 test). Cardiovascular collapse was defined as the occurrence of 1 or more of the following: a systolic blood pressure of less than 65 mm Hg between induction of anesthesia and 2 minutes after tracheal intubation; new or increased receipt of vasopressors between induction of anesthesia and 2 minutes after tracheal intubation; cardiac arrest within 1 hour of tracheal intubation; or death within 1 hour of tracheal intubation. Patients could experience more than 1 component of the composite primary outcome.
Data recorders were instructed to report no value for the lowest systolic blood pressure if no blood pressure reading could be obtained (eg, during cardiac arrest). All 6 patients for whom lowest systolic blood pressure was missing met the primary outcome of cardiovascular collapse; 1 such patient in the fluid bolus group died between induction of anesthesia and 1 hour after the procedure. 4 of these patients (3 in the fluid bolus group and 1 in the no fluid bolus group) experienced cardiac arrest between induction of anesthesia and 1 hour after the procedure, and all 6 had new or increased receipt of vasopressors between induction of anesthesia and 2 minutes after tracheal intubation.
Between induction of anesthesia and 2 minutes after completion of the tracheal intubation procedure.
Defined as the number of calendar days between enrollment and 28 days after enrollment in which the patient was alive and not receiving invasive mechanical ventilation after the patient’s final receipt of invasive mechanical ventilation. Patients who died before day 28 received a value of 0.
Calculated using the same approach as invasive mechanical ventilation–free days. Further details appear in eTable 10 in Supplement 2.