Hemodynamic and Metabolic Responses to Ketamine and Etomidate Sedations During Endotracheal Intubation in Critically ill Patients

Objective: The aim of this study was to compare the effects of etomidate and ketamine on hemodynamic and metabolic responses to intubation in ICU patients. Material and Method: After Clinical Research and Ethics Committee approval, 22 ICU patients who required intubation during their ICU stay were enrolled in this prospective, randomized, double-blinded study. Patients in group E (n=12) received etomidate 0.3 mg/kg IV and those randomized to group K (n=10) received ketamine 2 mg/kg IV for sedation during endotracheal intubation. Results: The demographic features, reasons for intubation and causes of ICU admission were similar between the groups (p>0.05). Mean heart rate and arterial blood pressure values were not significantly different between the two groups at the baseline and after intubation (p>0.05). Groups' mean serum cortisol and 11 beta-deoxycortisol concentrations were similar before and 5 minutes after intubation (p>0.05). The groups were not significantly different with regards to intubation conditions, mortality, length of ICU stay, and duration of mechanical ventilation (p>0.05). Mean sequential organ failure assesment (SOFA) scores during the first 9 days after intubation were also similar in both groups (p>0.05). Conclusion: Our results demonstrated that when used for endotracheal intubation of ICU patients, ketamine and etomidate are comparable in terms of hemodynamic and metabolic responses, intubation condition, and mean SOFA scores.