Front Med (Lausanne). 2026 Jun 26;13:1843544. doi: 10.3389/fmed.2026.1843544. eCollection 2026.
ABSTRACT
OBJECTIVE: To investigate what factors predispose patients with hypertensive intracerebral hemorrhage to develop hypotension after intubation, and to use this knowledge to direct treatment efforts away from hypotension and prevent further ischemia caused by it.
METHODS: This was a single-center, retrospective observational study. Of 451 patients with hypertensive intracerebral hemorrhage admitted to our emergency department between January 2019 and September 2022, 275 met the eligibility criteria and were included. Those patients were divided into hypotensive group (124 cases) and non-hypotensive group (151 cases) according to their blood pressure changes after intubation. The analysis compares the demographic data, vital signs, and laboratory results of the two groups of patients. Based on the comparison analysis, Logistic regression method was used to analyze indicators with statistical differences to determine the correlation between the selected variables and drop of blood pressure.
RESULTS: The differences between the two groups in age, weight, pre-existing cardiovascular and two or more diseases, BMI, albumin, and brain natriuretic peptide (BNP) were statistically significant. Logistic regression study found that individuals with intracerebral hemorrhage who were underweight or who had elevated BNP were more likely to experience post-intubation hypotension.
CONCLUSION: Older age, low body weight, combined cardiovascular and more than two diseases, hypoalbominemia, and elevated BNP were substantially connected with post-intubation hypotension, while low body weight and elevated BNP were significant independent predictors of post-intubation hypotension. To minimize the risk of secondary cerebral ischemia, emergency physicians should identify patients at high risk of post-intubation hypotension-particularly those with low body weight, multiple comorbidities, hypoalbuminemia or elevated BNP-and consider pre-emptive volume optimization and dose-adjusted induction prior to tracheal intubation.
PMID:42433977 | PMC:PMC13353085 | DOI:10.3389/fmed.2026.1843544