Ketamine versus Etomidate and Peri-Intubation Hypotension: A National Emergency Airway Registry Study.

BACKGROUND The hemodynamic impact of induction agents is a critically important consideration in emergency intubations. We assessed the relationship between peri-intubation hypotension and the use of ketamine versus etomidate as an induction agent for emergency department (ED) intubation. METHODS We analyzed ED intubation data for patients aged >14 years from the National Emergency Airway Registry performed in 25 EDs during 2016-2018. We excluded patients with pre-intubation hypotension (systolic blood pressure 1.0 mg/kg or patients receiving etomidate at doses ≤0.3 mg/kg vs. >0.3 mg/kg. CONCLUSIONS Pending additional data, our results suggest clinicians should not necessarily prioritize ketamine over etomidate based on concern for hemodynamic compromise among ED patients undergoing intubation.