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Research Snapshot Theater: Trauma, Adult II

Intubation and Cardiovascular Collapse in Trauma Patients: A Multi-Center Study

Tuesday, March 24, 2026
10:00 AM - 11:00 AM Central Time
Location: Connections Central - RST 17
  • JF

    Jacob Friedman, BS

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • HH

    Habin Hwang, BS

    Student
    Research Associate Program in Emergency Medicine & Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine

    Disclosure information not submitted.

  • Natalie Htet, MD, MS (she/her/hers)

    Stanford University Medical Center
    Stanford University, California

    Disclosure information not submitted.

  • JW

    Jennifer Walker, MD

    Emergency Medicine, Critical Care Medicine
    Baylor Scott & White Health

    Disclosure information not submitted.

  • CL

    Cassidy Lavin, BS

    Student
    University of Maryland School of Medicine

    Disclosure information not submitted.

  • DJ

    Daniel Jafari, MD, MPH

    Attending physician
    North Shore University Hospital

    Disclosure information not submitted.

  • NA

    Nicole Acquisto, BCCCP, PharmD, FCCM, FASHP, FCCP

    Associate Professor of Emergency Medicine
    Strong Memorial Hospital of the University of Rochester

    Disclosure information not submitted.

  • Quincy K. Tran, MD, PhD

    University of Maryland Medical Center, R. Adams Cowley Shock Trauma Center, Maryland

    Disclosure information not submitted.

Introduction: Endotracheal intubation is a common resuscitative procedure used in emergency and trauma medicine. While intubation may be lifesaving, it is associated with adverse effects. Previous research has shown trauma patients intubated without sedation in the field or with metabolic acidosis have poor outcomes (e.g., cardiovascular collapse, increased mortality). Our multi-center study aims to investigate factors associated with cardiovascular collapse when intubating trauma patients.


Methods: This is a retrospective multi-centered study of trauma patients ≥ 17 years old who required intubation at participating centers from 2020-2024. Patients with polytrauma, complex facial trauma, those with cardiac arrest prior to intubation, or those intubated in the field before emergency department (ED) arrival will be excluded. Outcomes will be the occurrence of peri-intubation adverse events, and in-hospital mortality. Cardiovascular collapse is defined as initiation of vasopressors and/or transfusion of packed red blood cells (pRBC) within one hour of intubation. Multivariable logistic regressions, using patient demographics, medical and laboratory variables at ED arrival will be used to identify patient- or procedure-specific risk factors associated with peri-intubation adverse events. Univariate logistic regressions will be performed to identify significant factors before adding them to the multivariable model. Data will be analyzed in 2 phases: derivation phase using data from the coordinating site and validation phase combining data from other contributing institutions.


Results: Derivation data includes 2446 trauma patients intubated between 2020-2024; mean age 47.5 years (± 19.4), 74.9% male. Overall, 982 (40.1%) patients had a peri-intubation adverse event; 135 (5.5%) had initiation of a vasopressor only, 615 (25.1%) from a pRBC transfusion only, and 232 (9.5%) from both vasopressors and pRBC transfusions. There were 269 (10.9%) mortality among our patient population.


Conclusions: Analysis is in progress, and complete results from the derivation phase will be presented during Congress in March 2026.