Randomized Trial of Sedative Choice for Intubation

• Status: Not yet recruiting
• Trial end date: 2025-10-04
• Target enrollment: 0
• Participant gender: All

Summary

Among critically ill adults undergoing emergency tracheal intubation, one in five experience hypotension, cardiac arrest, or death. The sedatives used to rapidly induce anesthesia for emergency tracheal intubation have been hypothesized to effect cardiovascular complications and patient outcomes, but the optimal sedative medication for intubation of critically ill adults remains unknown. Ketamine and etomidate are the two most commonly used sedatives during intubation of critically ill adults. Data from a randomized clinical trial are urgently needed to determine the effect of ketamine versus etomidate on cardiovascular complications and clinical outcomes of emergency tracheal intubation.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Vanderbilt University Medical Center
• Treatments: Etomidate; Ketamine

Criteria

Inclusion Criteria:

• Patient is critically ill and undergoing emergency tracheal intubation with sedation in an enrolling unit

• Planned procedure is orotracheal intubation using a laryngoscope

• Planned operator is a clinician expected to routinely perform tracheal intubation in the participating unit

Exclusion Criteria:

• Patient is known to be less than 18 years old

• Patient is known to be pregnant

• Patient is known to be a prisoner

• Patient is known to have an allergy to ketamine or etomidate

• Patient is presenting to the emergency department with a primary diagnosis of trauma

• Patient or LAR declines participation during pre-enrollment opt-out conversation or by wearing opt-out bracelet for the RSI trial

• Clinician feels ketamine is required or contraindicated for the optimal care of the patient

• Clinician feels etomidate is required or contraindicated for the optimal care of the patient

• Clinician feels an induction medication other than ketamine or etomidate is required for the optimal care of the patient

• Immediate need for intubation precludes safe performance of study procedures