Yang et al reported risk factors for peri-intubation cardiac arrest (PICA) in patients in the Emergency Department. This can help to identify a patient who may require more aggressive management. The authors are from Chang Gung Memorial Hospital in Taiwan.

Patient selection: intubation in the Emergency Department (ED)


Outcome: peri-intubation cardiac arrest (PICA)


Independent predictors of PICA:

(1) cardiogenic pulmonary edema as indication for intubation (aOR 5.9)

(2) systolic blood pressure < 90 mm Hg (aOR 5.2)

(3) elevated serum lactate concentration in mmol/L (aOR 1.01 per 0.11 mmol/L increase)



• A 0.11 mmol/L rise in serum lactate is equivalent to an increase of 1 mg/dL.


The risk of cardiac arrest increases with the number of risk factors present.

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