Etomidate versus ketamine for in-hospital rapid sequence intubation: a systematic review and meta-analysis.
European journal of emergency medicine : official journal of the European Society for Emergency Medicine June 1, 2025 Mohamed Aziz Daghmouri, Mohamed Ali Chaouch, Mohamed Noomen et al. 8 citations
Among critically ill patients undergoing rapid sequence intubation (RSI) in hospitals, ketamine and etomidate show no significant difference in 30-day survival. The meta-analysis of 14 studies with 23,926 patients found that etomidate use was linked to a higher rate of adrenal insufficiency, while ketamine required more post-intubation vasopressor support. Intubation difficulty, cardiovascular collapse, and systemic steroid use did not differ between the two agents. The findings suggest both drugs are comparable for short-term survival, but each carries distinct side-effect profiles that may guide clinical choice.