Ketamine, Etomidate, and Mortality in Emergency Department Intubations

Among critically ill adults undergoing rapid sequence intubation, is etomidate use associated with higher in-hospital mortality than ketamine?In this cohort study using target trial emulation with inverse probability of treatment weighting and data from 18 Brazilian emergency departments, etomidate was associated with significantly higher risks of in-hospital mortality at 28 days (60.5% vs 54.4%) and 7 days (35.2% vs 30.1%) compared with ketamine.These findings suggest that etomidate may increase the risk of death and support reevaluating its role in emergency airway management for critically ill adults.

Corresponding Author: Ian Ward A. Maia, MD, PhD, Department of Emergency Medicine, Faculdade de Medicina da Universidade de Sao Paulo, Av Dr Enéas Carvalho de Aguiar, 255 - Cerqueira César, São Paulo, SP 05403-000, Brasil (ian.ward@hc.fm.usp.br).

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