Trial reportIntensive care medicine2022
Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial.
Trial report in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 5 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 5 syntheses or guidelines pooled it, 153 citations in OpenAlex.
- Induction agents for emergency tracheal intubation in critically ill adults: a systematic review and network meta-analysis.Critical care (London, England) · 2026Pooled it
- Efficacy of ketamine versus etomidate for rapid sequence intubation of critically ill patients in terms of mortality and success rate: a systematic review and meta-analysis of randomized controlled trials.Clinical and experimental 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
- The impact of ketamine on emergency rapid sequence intubation: a systematic review and meta-analysis.BMC emergency medicine · 2024Pooled it
- Ketamine versus etomidate as an induction agent for tracheal intubation in critically ill adults: a Bayesian meta-analysis.Critical care (London, England) · 2024Pooled it
- Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults.The New England journal of medicine · 2026Trial
- Propofol versus ketamine in rapid sequence intubation in critically ill patients: a prospective, randomized, controlled trial.Intensive care medicine · 2026Trial
- Comparison of the Efficacy of Ciprofol and Propofol for Rapid Sequence Induction and Intubation in Elective Non-Cardiac Surgery: A Prospective, Randomized, Non-Inferiority Trial.Drug design, development and therapy · 2026Trial
- Efficacy and safety of esketamine for emergency endotracheal intubation in ICU patients: a double-blind, randomized controlled clinical trial.Scientific reports · 2025Trial
- Comparing the hemodynamic effects of ketamine versus fentanyl bolus in patients with septic shock: a randomized controlled trial.Journal of anesthesia · 2024Trial
- Trial
- Clinical outcomes after a single induction dose of etomidate versus ketamine for emergency department sepsis intubation: a randomized controlled trial.Scientific reports · 2023Trial
- Remimazolam vs Etomidate: Haemodynamic Effects in Hypertensive Elderly Patients Undergoing Non-Cardiac Surgery.Drug design, development and therapy · 2023Trial
- Comparison of Remimazolam Tosilate and Etomidate on Hemodynamics in Cardiac Surgery: A Randomised Controlled Trial.Drug design, development and therapy · 2023Trial
- Etomidate Is Associated with Higher 30-Day Mortality than Ketamine for Emergency Intubation of COVID-19 Patients: A Propensity-Matched Cohort Study.Journal of clinical medicine · 2026Article
- Evaluating Ketamine Dosing Practices During Emergency Department Intubation Using Shock Index Stratification.Cureus · 2026Article
- The hemodynamics of tracheal intubation in critically ill patients: a narrative review.Journal of intensive care · 2026Review
- Review
- Observational
- 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
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Authors and funding
18 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeEtomidate and ketamine are hemodynamically stable induction agents often used to sedate critically ill patients during emergency endotracheal intubation. In 2015, quality improvement data from our hospital suggested a survival benefit at Day 7 from avoidance of etomidate in critically ill patients during emergency intubation. In this clinical trial, we hypothesized that randomization to ketamine instead of etomidate would be associated with Day 7 survival after emergency endotracheal intubation.
methodsA prospective, randomized, open-label, parallel assignment, single-center clinical trial performed by an anesthesiology-based Airway Team under emergent circumstances at one high-volume medical center in the United States. 801 critically ill patients requiring emergency intubation were randomly assigned 1:1 by computer-generated, pre-randomized sealed envelopes to receive etomidate (0.2-0.3 mg/kg, n = 400) or ketamine (1-2 mg/kg, n = 401) for sedation prior to intubation. The pre-specified primary endpoint of the trial was Day 7 survival. Secondary endpoints included Day 28 survival.
resultsOf the 801 enrolled patients, 396 were analyzed in the etomidate arm, and 395 in the ketamine arm. Day 7 survival was significantly lower in the etomidate arm than in the ketamine arm (77.3% versus 85.1%, difference - 7.8, 95% confidence interval - 13, - 2.4, p = 0.005). Day 28 survival rates for the two groups were not significantly different (etomidate 64.1%, ketamine 66.8%, difference - 2.7, 95% confidence interval - 9.3, 3.9, p = 0.294).
conclusionWhile the primary outcome of Day 7 survival was greater in patients randomized to ketamine, there was no significant difference in survival by Day 28.
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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.