The effect between etomidate and ketamine on peri-intubation hypotension in elderly patients in the emergency department.
The American journal of emergency medicine May 16, 2025 Praphaphorn Supatanakij, Thitipat Mungjadetanadee, Nitchakarn Boonyok et al. 2 citations
Among elderly patients in the emergency department requiring tracheal intubation, the incidence of peri-intubation hypotension (PIH) was 44.1% with etomidate and 53.2% with ketamine, a difference that was not statistically significant. 28-day mortality was 36.0% for etomidate and 25.2% for ketamine, also not statistically significant overall. However, in patients who developed PIH and required vasopressors, ketamine was associated with a lower risk of 28-day mortality. Among patients with a shock index of 0.9 or higher, higher doses of either induction agent increased the probability of PIH. The findings suggest no clear advantage of one agent over the other for preventing PIH or reducing mortality in this population.