Trial reportThe Lancet. Respiratory medicine2019
Effect of a fluid bolus on cardiovascular collapse among critically ill adults undergoing tracheal intubation (PrePARE): a randomised controlled trial.
Trial report in The Lancet. Respiratory medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 52 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Preventing Cardiovascular collaPse With Administration of Fluid Resuscitation Before Endotracheal Intubation: The PrePARE Trial
Preventing Cardiovascular Collapse With Vasopressors During Tracheal Intubation. The PREVENTION Randomized Multicenter Study
Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- Impact of Interventions on Peri-Intubation Hypoxemia and Hypotension in Critically Ill Patients: Systematic Review and Meta-Analysis.The western journal of emergency medicine · 2025Pooled it
- Incidence of post-induction hypotension following emergency rapid sequence induction with ketamine: a systematic review and meta-analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Pooled it
- Comparing the hemodynamic effects of ketamine versus fentanyl bolus in patients with septic shock: a randomized controlled trial.Journal of anesthesia · 2024Trial
- Trial
- Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial.Intensive care medicine · 2022Trial
- Risk Factors for Cardiovascular Collapse during Tracheal Intubation of Critically III Adults.Annals of the American Thoracic Society · 2020Trial
- Airway management in critically ill patients with obesity.Intensive care medicine · 2026Review
- The hemodynamics of tracheal intubation in critically ill patients: a narrative review.Journal of intensive care · 2026Review
- The Pharmacology of Physiologically Difficult Airway Management and Impact on Hemodynamics: A Review.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Review
- Best practices in airway management in critically ill adults.Intensive care medicine · 2025Article
- Peri-intubation Cardiovascular Collapse During Emergency Airway Management.Pulmonary therapy · 2025Review
- Integrating Rapid Cardiopulmonary and Gastric Ultrasound for Emergency Airway Management in Critically Ill Patients: A Case Series of Resident-Performed Echocardiographic Assessment Using Subcostal-Only-View in Physiologically Difficult Airway.Critical care explorations · 2025Article
- Making endotracheal intubation safe in intensive care units: Impact of a bundle on the complications related to endotracheal intubation: A quasi-experimental before-after study.Indian journal of anaesthesia · 2025Article
- Airway management in critically ill patients.BJA education · 2025Review
- Evidence-based Emergency Tracheal Intubation.American journal of respiratory and critical care medicine · 2025Review
- Peri-intubation adverse events and clinical outcomes in emergency department patients: the BARCO study.Critical care (London, England) · 2025Article
- Interventions to Reduce Risk in the Physiologically Difficult Pediatric Airway: A Descriptive Study and Exploratory Analysis.Journal of the American College of Emergency Physicians open · 2025Article
- Evaluation of MACOCHA Score for Predicting Difficult Intubation in Critically Ill Cancer Patients: A Prospective Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
- Intubation bundle: A prospective observational tertiary cancer centre study of clinical practice and adverse events of tracheal intubation out of operation theatre.Northern clinics of Istanbul · 2025Article
- Tracheal intubation in critically ill adults with a physiologically difficult airway. An international Delphi study.Intensive care medicine · 2024Article
Corrections and comments
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Authors and funding
20 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundTracheal intubation is common in the care of critically ill adults and is frequently complicated by hypotension, cardiac arrest, or death. We aimed to evaluate administration of an intravenous fluid bolus to prevent cardiovascular collapse during intubation of critically ill adults.
methodsWe did a pragmatic, multicentre, unblinded, randomised trial in nine sites (eight ICUs and one emergency department) around the USA. Critically ill adults (≥18 years) undergoing tracheal intubation were randomly assigned (1:1, block sizes of 2, 4, and 6, stratified by study site) to either an intravenous infusion of 500 mL of crystalloid solution or no fluid bolus. The primary outcome, assessed in the intention-to-treat population, was cardiovascular collapse, defined as a new systolic blood pressure <65 mm Hg; new or increased vasopressor receipt between induction and 2 min after tracheal intubation; or cardiac arrest or death within 1 h of tracheal intubation. Adverse events were assessed in the as-treated population. This trial, which is now complete, is registered with ClinicalTrials.gov, number NCT03026777.
findingsPatients were enrolled from Feb 6, 2017, to Jan 9, 2018, when the data and safety monitoring board stopped the trial on the basis of futility. By trial termination, 337 (63%) of 537 screened adults had been randomly assigned. Cardiovascular collapse occurred in 33 (20%) of 168 patients in the fluid bolus group compared with 31 (18%) of 169 patients in the no fluid bolus group (absolute difference 1·3% [95% CI -7·1% to 9·7%]; p=0·76). The individual components of the cardiovascular collapse composite outcome did not differ between groups (new systolic blood pressure <65 mm Hg 11 [7%] in the bolus group vs ten [6%] in the no-bolus group, new or increased vasopressor 32 [19%] vs 31 [18%], cardiac arrest within 1 h seven [4%] vs two [1%], death within 1 h of intubation two [1%] vs one [1%]). In-hospital mortality was not significantly different in the fluid bolus group (48 [29%]) compared with no fluid bolus (59 [35%]).
interpretationAdministration of an intravenous fluid bolus did not decrease the overall incidence of cardiovascular collapse during tracheal intubation of critically ill adults compared with no fluid bolus in this trial.
fundingUS National Institutes of Health.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.