Randomized Trial of Sedative Choice for Intubation

Description

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.

Conditions

Acute Respiratory Failure

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Study Overview

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Study Details

Study overview

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.

The Randomized Trial of Sedative Choice for Intubation

Randomized Trial of Sedative Choice for Intubation

Condition
Acute Respiratory Failure
Intervention / Treatment

-

Contacts and Locations

Birmingham

UAB Hospital, Birmingham, Alabama, United States, 35233

Aurora

University of Colorado Denver, Aurora, Colorado, United States, 80045

Denver

Denver Health Medical Center, Denver, Colorado, United States, 80204

Minneapolis

Hennepin County Medical Center, Minneapolis, Minnesota, United States, 55415

Winston-Salem

Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States, 27157

Nashville

Vanderbilt University Medical Center, Nashville, Tennessee, United States, 37232

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility 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
  • * 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

Ages Eligible for Study

18 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Vanderbilt University Medical Center,

Jonathan D Casey, MD, MSc, PRINCIPAL_INVESTIGATOR, Vanderbilt University Medical Center

Matthew W Semler, MD, MSc, STUDY_CHAIR, Vanderbilt University Medical Center

Todd W Rice, MD, MSc, STUDY_DIRECTOR, Vanderbilt University Medical Center

Wesley H Self, MD, MPH, STUDY_DIRECTOR, Vanderbilt University Medical Center

Study Record Dates

2027-02-01