Comparing ketamine and etomidate for sedation during emergency intubation
The Randomized Trial of Sedative Choice for Intubation
This study is testing whether ketamine or etomidate is safer for sedating critically ill adults during emergency intubation to see which one leads to fewer heart problems and complications.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Enrollment | 2364 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Vanderbilt University Medical Center Academic / other |
| Locations | 6 sites (Birmingham, Alabama and 5 other locations) |
| Trial ID | NCT05277896 on ClinicalTrials.gov |
What this trial studies
This clinical trial aims to determine the effects of two commonly used sedatives, ketamine and etomidate, on cardiovascular complications and clinical outcomes during emergency tracheal intubation in critically ill adults. The study will enroll patients undergoing orotracheal intubation and will compare the incidence of hypotension, cardiac arrest, and other serious complications associated with each sedative. By addressing a significant knowledge gap in emergency airway management, this trial seeks to improve patient safety and outcomes during a critical procedure. The results could provide essential data to guide best practices in sedation for intubation.
Who should consider this trial
Good fit: Ideal candidates for this study are critically ill adults who require emergency tracheal intubation.
Not a fit: Patients under 18 years old, pregnant individuals, or those with allergies to ketamine or etomidate will not benefit from this study.
Why it matters
Potential benefit: If successful, this study could lead to improved safety and reduced complications during emergency intubation for critically ill patients.
How similar studies have performed: Other studies have indicated the importance of sedative choice in intubation outcomes, but this specific comparison of ketamine versus etomidate is novel and urgently needed.
Eligibility criteria
Show full inclusion / exclusion 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
Where this trial is running
Birmingham, Alabama and 5 other locations
- UAB Hospital — Birmingham, Alabama, United States (Recruiting)
- University of Colorado Denver — Aurora, Colorado, United States (Recruiting)
- Denver Health Medical Center — Denver, Colorado, United States (Recruiting)
- Hennepin County Medical Center — Minneapolis, Minnesota, United States (Recruiting)
- Wake Forest Baptist Medical Center — Winston-Salem, North Carolina, United States (Recruiting)
- Vanderbilt University Medical Center — Nashville, Tennessee, United States (Recruiting)
Study contacts
- Principal investigator: Jonathan D Casey, MD, MSc — Vanderbilt University Medical Center
- Study coordinator: Jonathan D Casey, MD, MSc
- Email: Jonathan.d.Casey@vumc.org
- Phone: 615-875-4681
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.