Post-induction hypotension during rapid sequence intubation in the operating room: A post hoc analysis of the randomized controlled REMICRUSH trial
Authors' conclusion
Post-induction hypotension was frequent during rapid sequence intubation. Sedation associating propofol with low doses of ketamine was associated with a low risk of post-induction hypotension.
Study context
- Population
- Adults at risk for aspiration undergoing tracheal intubation (RSI) in the operating room, 15 hospitals
- Participants
- 1,137 adults · 15 hospitals
- Comparison
- Risk factors for post-induction hypotension during RSI
- Primary endpoint
- Post-induction hypotension (MBP ≤ 55 mmHg and/or SBP ≤ 80 mmHg)
- Follow-up
- Within 10 min after anesthetic induction
Methodological detailspost hoc analysis, multicentre, Propofol used in 1117 (98%); with low-dose ketamine in 209 (18 %)
- Post hoc analysis
- Multicentre
- Propofol used in 1117 (98%); with low-dose ketamine in 209 (18 %)
Primary result
As reported in the abstract
Post-induction hypotension: incidence and independent risk factors
Odds ratio (95% CI)P value
Ageindependent risk factor
1.03(1.02–1.04)
P < 0.0001Bowel occlusion requiring nasogastric tube placement before intubationindependent risk factor
1.96(1.33–2.87)
P = 0.0006Use of remifentanilindependent risk factor
3.54(2.61–4.81)
P < 0.0001Use of low doses of ketamineprotective factor
0.61(0.41–0.92)
P = 0.0175Basal SBPprotective factor
0.98(0.97–0.99)
P < 0.0001- Patients with post-induction hypotension
- 291 (26%)
- AUC of final model for post-induction hypotension prediction
- 0.74 [95% CI 0.71; 0.77]
Further findings
Final model precision for post-induction hypotension prediction
- AUC
- 0.74 [95% CI 0.71; 0.77]
Original publication
Post-induction hypotension during rapid sequence intubation in the operating room: A post hoc analysis of the randomized controlled REMICRUSH trial. Anaesth Crit Care Pain Med. Published 12 March 2025. doi:10.
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