Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults
Primary resultResult — go to the resultRisk difference −0.8 percentage points 95% CI −4.5 to 2.9Authors' conclusion
Among critically ill adults undergoing tracheal intubation, the use of ketamine to induce anesthesia did not result in a significantly lower incidence of in-hospital death by day 28 than etomidate.
Study context
- Population
- Critically ill adults undergoing tracheal intubation in 14 EDs and ICUs in the US
- Participants
- 2,365 adults
- Comparison
- Ketamine vs Etomidate
- Ketaminen = 1,176
- Etomidaten = 1,189reference
- Primary endpoint
- In-hospital death from any cause
- Follow-up
- Day 28
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
Risk difference
−0.8 percentage points
95% CI −4.5 to 2.9
P = 0.65
Events by treatment group
Ketamine vs Etomidate
risk difference −0.8 percentage points (95% CI −4.5 to 2.9); P = 0.65
Secondary outcomes
| Outcome | Ketamine | Etomidate | Risk difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| Cardiovascular collapse during intubation (SBP <65 mm Hg, new or increased vasopressor dose, or cardiac arrest) | 22.1% | 17.0% | 5.1 (1.9–8.3) | |
| −50510Difference, percentage points (linear scale) |
Safety
Prespecified safety outcomes
- Similar in the two groups
Original publication
Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. N Engl J Med. Published 9 December 2025. doi:10.
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