TY - JOUR
T1 - Intubation and Mechanical Ventilation in Patients with Acute Pulmonary Embolism
T2 - A Scoping Review
AU - Lee, Eun Sang
AU - Baltsen, Cecilie Dahl
AU - Stubblefield, William B
AU - Granfeldt, Asger
AU - Andersen, Asger
AU - Stannek, Karsten
AU - Dudzinski, David M
AU - Kabrhel, Christopher
AU - Lyhne, Mads Dam
PY - 2026/1
Y1 - 2026/1
N2 - OBJECTIVES: High-risk acute pulmonary embolism (PE) is associated with significant mortality and may require emergency endotracheal intubation and mechanical ventilation. Intubation and ventilation are thought to exacerbate cardiorespiratory instability. Our purpose was to conduct a systematic literature review to identify studies investigating peri-intubation events in acute PE.METHODS: A systematic search of Medline, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library was performed. Results were screened by two independent observers. Studies reporting on intubation and positive pressure ventilation in acute PE patients were included. The primary outcome was adverse events during the peri-intubation period. Data was synthesized and an assessment of risk of bias was conducted. The review was registered on PROSPERO (CRD42023444483).RESULTS: 4100 unique articles were screened. Three retrospective studies comprising 104 patients with acute PE met criteria and were included. Peri-intubation, hemodynamic collapse was observed in 19%-28% of cases. Patients with hemodynamic collapse exhibited higher rates of echocardiographic RV dysfunction.CONCLUSIONS: Peri-intubation adverse events are common in patients with acute PE. Current evidence is limited and highlights the need for further research to optimize management of respiratory failure in acute PE and patient selection for intubation to improve patient outcomes.
AB - OBJECTIVES: High-risk acute pulmonary embolism (PE) is associated with significant mortality and may require emergency endotracheal intubation and mechanical ventilation. Intubation and ventilation are thought to exacerbate cardiorespiratory instability. Our purpose was to conduct a systematic literature review to identify studies investigating peri-intubation events in acute PE.METHODS: A systematic search of Medline, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library was performed. Results were screened by two independent observers. Studies reporting on intubation and positive pressure ventilation in acute PE patients were included. The primary outcome was adverse events during the peri-intubation period. Data was synthesized and an assessment of risk of bias was conducted. The review was registered on PROSPERO (CRD42023444483).RESULTS: 4100 unique articles were screened. Three retrospective studies comprising 104 patients with acute PE met criteria and were included. Peri-intubation, hemodynamic collapse was observed in 19%-28% of cases. Patients with hemodynamic collapse exhibited higher rates of echocardiographic RV dysfunction.CONCLUSIONS: Peri-intubation adverse events are common in patients with acute PE. Current evidence is limited and highlights the need for further research to optimize management of respiratory failure in acute PE and patient selection for intubation to improve patient outcomes.
KW - anesthesia
KW - cardiopulmonary interactions
KW - intensive care
KW - pulmonary circulation
KW - right ventricular function
UR - https://www.scopus.com/pages/publications/85205357719
U2 - 10.1177/08850666241285862
DO - 10.1177/08850666241285862
M3 - Review
C2 - 39318344
SN - 0885-0666
VL - 41
SP - 3
EP - 11
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 1
ER -