Evidence map›Paper›PMID 35064992›Full record

Trial reportAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2022

Fentanyl versus placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department: The FAKT study-A randomized clinical trial.

Ian Ferguson, Alexander Buttfield, Brian Burns, Cliff Reid, Shamus Shepherd, James Milligan, Ian A Harris, Anders Aneman, Australasian College for Emergency Medicine Clinical Trials Network

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
10.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 2 countries.

Ian FergusonSouth West Clinical School, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0001-5915-6315
Alexander ButtfieldUniversity of Western Sydney, Sydney, New South Wales, Australia.
Brian BurnsGSA-HEMS, NSW Ambulance, Bankstown Aerodrome, Sydney, New South Wales, Australia.
Cliff ReidGSA-HEMS, NSW Ambulance, Bankstown Aerodrome, Sydney, New South Wales, Australia.
Shamus ShepherdOrange Health Service, Orange, New South Wales, Australia.
James MilliganRoyal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia.
Ian A HarrisSouth West Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
Anders AnemanSouth West Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
Australasian College for Emergency Medicine Clinical Trials Network
The University of Sydney · AUCamden and Campbelltown Hospitals · AUFlorida Department of Health in Orange County · USLiverpool Hospital · AUNSW Ambulance · AURoyal North Shore Hospital · AUUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective was to determine whether the use of fentanyl with ketamine for emergency department (ED) rapid sequence intubation (RSI) results in fewer patients with systolic blood pressure (SBP) measurements outside the pre-specified target range of 100-150 mm Hg following the induction of anesthesia. Methods This study was conducted in the ED of five Australian hospitals. A total of 290 participants were randomized to receive either fentanyl or 0.9% saline (placebo) in combination with ketamine and rocuronium, according to a weight-based dosing schedule. The primary outcome was the proportion of patients in each group with at least one SBP measurement outside the prespecified range of 100-150 mm Hg (with adjustment for baseline abnormality). Secondary outcomes included first-pass intubation success, hypotension, hypertension and hypoxia, mortality, and ventilator-free days 30 days following enrollment.

resultsA total of 142 in the fentanyl group and 148 in the placebo group commenced the protocol. A total of 66% of patients receiving fentanyl and 65% of patients receiving placebo met the primary outcome (difference = 1%, 95% CI = -10 to 12). Hypotension (SBP ≤ 99 mm Hg) was more common with fentanyl (29% vs. 16%; difference = 13%, 95% CI = 3% to 23%), while hypertension (≥150 mm Hg) occurred more with placebo (69% vs. 55%; difference = 14%, 95% CI = 3 to 24). First-pass success rate, 30 day mortality, and ventilator-free days were similar. CONCLUSIONS AND RELEVANCE: There was no difference in the primary outcome between groups, although lower blood pressures were more common with fentanyl. Clinicians should consider baseline hemodynamics and postinduction targets when deciding whether to use fentanyl as a coinduction agent with ketamine.

Indexed as

HypertensionHypotensionKetamineAustraliaEmergency Service, HospitalFentanylHumansIntubation, IntratrachealRapid Sequence Induction and IntubationRocuroniumFentanylKetamineRocuronium

Identifiers

PMID35064992
PMCPMC9314707
OpenAlexW4207050154

What OpenQuestion holds

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Registered trials

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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.