Randomized Trial of Sedative Choice for Intubation

Completed · Phase 4

Conditions studied: Acute Respiratory Failure

In brief

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.

Key facts

Study ID

NCT05277896

Run by

Vanderbilt University Medical Center

People needed

2367

Starts

2022-04-06

Expected to finish

2025-09-06

Last updated by the study team

2026-03-25

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• 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

You may not qualify if…

• 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 it is running

• UAB Hospital — Birmingham, Alabama, United States
• University of Colorado Denver — Aurora, Colorado, United States
• Denver Health Medical Center — Denver, Colorado, United States
• Hennepin County Medical Center — Minneapolis, Minnesota, United States
• Wake Forest Baptist Medical Center — Winston-Salem, North Carolina, United States
• Vanderbilt University Medical Center — Nashville, Tennessee, United States

Full record on ClinicalTrials.gov

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