Etomidate versus Ketamine as Prehospital Induction Agent in Patients with Suspected Severe Traumatic Brain Injury
Authors' conclusion
The analysis found no evidence for an association between the use of etomidate or S(+)-ketamine as an anesthetic agent for intubation in patients with traumatic brain injury and mortality after 30 days in the prehospital setting
Study context
- Population
- Patients with suspected severe TBI transported to a participating trauma centre who received prehospital advanced airway management, Netherlandseligible for analysis
- Participants
- 1,457 patients
- Exposure
- Etomidate vs S-ketamine for prehospital induction of anaesthesia
- Outcome
- Mortality
- Follow-up
- 30 days
Methodological detailsBRAIN-PROTECT, multivariable logistic regression, inverse probability of treatment weighting
- BRAIN-PROTECT
- Multivariable logistic regression
- Inverse probability of treatment weighting
Main finding
As reported in the abstract
30-day mortality
Etomidate vs S(+)-ketamineOdds ratio (95% CI)P value
Unadjusted; P = 0.716 for proportions
1.04(0.83–1.32)
P = 0.711Adjusted for potential confounders
1.08(0.67–1.73)
P = 0.765Etomidate vs S(+)-ketamineRisk difference (95% CI)P value
Adjusted for potential confounders
0.017(−0.051 to 0.084)
P = 0.686Observational data: associations, not effects.
Further findings
30-day mortality in confirmed TBI and isolated TBI (planned subgroups)
- No significant differences
Original publication
Etomidate versus Ketamine as Prehospital Induction Agent in Patients with Suspected Severe Traumatic Brain Injury. Anesthesiology. Published 8 January 2024. doi:10.
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