Trial reportThe New England journal of medicine2026
Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults.
Trial report in The New England journal of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05277896 (The Randomized Trial of Sedative Choice for Intubation), which is not on this map. Cited by 17 papers, 1 of them a synthesis 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.
The Randomized Trial of Sedative Choice for Intubation
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Induction agents for emergency tracheal intubation in critically ill adults: a systematic review and network meta-analysis.Critical care (London, England) · 2026Pooled it
- Comments on 'Anesthetic induction drugs during tracheal intubation in critically ill patients: a systematic review' by Yatabe et al.Journal of anesthesia · 2026Article
- Prehospital airway and ventilatory management: a collaborative and narrative review.Intensive care medicine · 2026Review
- Hemodynamic Effects of Anesthetics, Sedatives, and Analgesics in the CICU: Clinical Decision Guidance.JACC. Advances · 2026Review
- [Ketamine or etomidate for emergency intubation of critically ill patients: no mortality benefit with ketamine, but increased hemodynamic instability].Die Anaesthesiologie · 2026Article
- Article
- 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
- Hemodynamic stability should not re-establish etomidate as the default induction agent.Critical care (London, England) · 2026Article
- Airway management in critically ill patients with obesity.Intensive care medicine · 2026Review
- Evaluating Ketamine Dosing Practices During Emergency Department Intubation Using Shock Index Stratification.Cureus · 2026Article
- Community consultation and public disclosure for the Randomized Trial of Sedative Choice for Intubation.Trials · 2026Article
- The hemodynamics of tracheal intubation in critically ill patients: a narrative review.Journal of intensive care · 2026Review
- Review
- Fentanyl as an induction agent for tracheal intubation in critically ill patients: a systematic review and meta-analysis.Journal of intensive care · 2026Article
- Airway Management in the ICU and Emergency Department in Resource-Limited Settings.Life (Basel, Switzerland) · 2026Review
- 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
- A Retrospective Comparison of Etomidate and Ketamine for Prehospital Rapid Sequence Intubation.Air medical journalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
45 authors.
Funding
Abstract
backgroundFor critically ill adults undergoing tracheal intubation, observational studies suggest that the use of etomidate to induce anesthesia may increase the risk of death. Whether the use of ketamine rather than etomidate decreases the risk of death is uncertain.
methodsIn a randomized trial conducted in 14 emergency departments and intensive care units in the United States, we randomly assigned critically ill adults who were undergoing tracheal intubation to receive ketamine or etomidate for the induction of anesthesia. The primary outcome was in-hospital death from any cause by day 28. The secondary outcome was cardiovascular collapse during intubation, defined by the occurrence of a systolic blood pressure below 65 mm Hg, receipt of a new or increased dose of vasopressors, or cardiac arrest.
resultsA total of 2365 patients underwent randomization and were included in the trial population; 1176 were assigned to the ketamine group and 1189 to the etomidate group. In-hospital death by day 28 occurred in 330 of 1173 patients (28.1%) in the ketamine group and in 345 of 1186 patients (29.1%) in the etomidate group (risk difference adjusted for trial site, -0.8 percentage points; 95% confidence interval [CI], -4.5 to 2.9; P = 0.65). Cardiovascular collapse during intubation occurred in 260 of 1176 patients (22.1%) in the ketamine group and in 202 of 1189 patients (17.0%) in the etomidate group (risk difference, 5.1 percentage points; 95% CI, 1.9 to 8.3). Prespecified safety outcomes were similar in the two groups.
conclusionsAmong critically ill adults undergoing tracheal intubation, the use of ketamine to induce anesthesia did not result in a significantly lower incidence of in-hospital death by day 28 than etomidate. (Funded by the Patient-Centered Outcomes Research Institute and others; RSI ClinicalTrials.gov number, NCT05277896.).
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