UMEM Educational Pearls

Peri-Intubation Cardiac Arrest

  • Emergency intubation is a common critical care procedure that carries the risk of life-threatening complications.
  • Although cardiac arrest (CA) is an established complication, there is scant literature on the actual incidence ad factors associated with CA in the peri-intubation period.
  • In a recent retrospective analysis from Carolinas Medical Center, investigators found:
    • Peri-intubation CA occurred in 4.2% of patients and was associated with a 14-fold increase in hospital mortality.
    • A pre-RSI shock index > 0.9 was indepedently associated with CA.
    • Obese patients had a higher incidence of CA; odds of CA increased 1.37 times for every 10 kg increase in weight.
  • Take Home Point: Peri-intubation CA may be more common than previously thought and, not suprisingly, is associated with an increased risk of in-hospital death.


Heffner AC, Swords DS, Neale MN, Jones AE. Incidence and factors associated with cardiac arrest complicating emergency airway management. Resuscitation 2013. [Epub ahead of print].