פוסט זה זמין גם ב:
עברית
Sarah KS Knack , Matthew E Prekker , Johanna C Moore , Lauren R Klein , Alexandra H Atkins , James J Miner ,
Brian E Driver
ABSTRACT 
Background
The use of induction agents for rapid sequence intubation (RSI) has been associated with hypotension in critically ill patients. Choice of induction agent may be important and the most commonly used agents are etomidate and ketamine
Objective
This study aimed to compare the effects of a single dose of ketamine versus etomidate for rapid sequence intubation (RSI) on maximum SOFA score and incidence of hypotension.
Methods
This single-center randomized parallel-group trial compared the use of ketamine and etomidate for RSI in critically ill emergency department adult patients. The study was performed under Exception from Informed Consent (EFIC). The primary outcome was the maximum SOFA score within 3 days of hospitalization.
Results
A total of 143 patients were enrolled in the trial, 70 in the ketamine group and 73 in the etomidate group. Maximum median SOFA score for the ketamine group was 6.5 (IQR 5-9) versus 7 (IQR 5-9) for etomidate with no significant difference (-0.2, 95% CI -1.4 to 1.1, p=0.79). The incidence of post-intubation hypotension was 28% in the ketamine group versus 26% in the etomidate group (difference 2%, 95% CI -13% to 17%). There were no significant differences in intensive care unit outcomes. Thirty-day mortality for the ketamine group was 8 deaths (11%) and etomidate was 15 deaths (21%), which was not statistically different.
Conclusion
There were no significant differences in maximum SOFA score or post-intubation hypotension between critically ill adults receiving ketamine versus etomidate for RSI.
