Assessment of Hemodynamic Responses at Adequate Depth of Anesthesia Using Bispectral Index During Rapid Sequence Intubation in the Emergency Department

Recruiting now

Conditions studied: Critical Illness

In brief

Rapid sequence intubation (RSI) is the standard approach for emergency airway management in critically ill patients requiring endotracheal intubation. Laryngoscopy and tracheal intubation may provoke significant hemodynamic responses, including increases in heart rate and blood pressure, which may adversely affect patients with severe neurological or cardiovascular disease. Although hemodynamic responses during tracheal intubation have been extensively investigated in the anesthesiology literature, evidence from emergency department settings remains limited. Furthermore, previous studies have rarely confirmed whether an adequate depth of anesthesia had been achieved before laryngoscopy, making interpretation of hemodynamic responses difficult. The aim of this prospective observational study is to evaluate hemodynamic responses during rapid sequence intubation in adult emergency department patients after confirming adequate depth of anesthesia using bispectral index (BIS) monitoring. Heart rate and blood pressure will be recorded before induction, during intubation, and after successful endotracheal intubation, allowing objective assessment of the hemodynamic response under confirmed adequate anesthetic depth.

Key facts

Study ID

NCT07722897

Run by

Akdeniz University Hospital

People needed

200

Starts

2026-05-01

Expected to finish

2028-05-01

Last updated by the study team

2026-07-23

Who can join

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

You may qualify if…

• Adults aged 18 years or older. Patients undergoing rapid sequence intubation (RSI) in the emergency department.
• Patients in whom bispectral index (BIS) monitoring can be applied before laryngoscopy.
• Patients achieving an adequate depth of anesthesia (BIS 45-55) before laryngoscopy.
• Written informed consent obtained from the patient or a legally authorized representative, when applicable according to local ethics requirements.

You may not qualify if…

• Age <18 years. Cardiac arrest before or during induction. Patients requiring immediate ("crash") intubation without sufficient time for BIS monitoring.
• Inability to obtain reliable BIS monitoring (e.g., technical failure or inability to place the sensor).
• Pregnancy. Facial or scalp conditions preventing BIS sensor placement. Prisoners or other vulnerable populations if excluded by the ethics protocol.

Where it is running

• Akdeniz University Hospital — Antalya, Turkey (Türkiye) (enrolling)

Full record on ClinicalTrials.gov

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