Esketamine Induction Intubation in ICU Patients.
Critically Ill Patients
About this trial
This is an interventional prevention trial for Critically Ill Patients focused on measuring Esketamine, Tracheal intubation, Hemodynamics
Eligibility Criteria
Inclusion Criteria:
- Patients aged 18-80 years old without restriction of gender, race, religion, creed or nationality;
- No sedative drugs with elimination half-life were used before inclusion in the study;
- Patients and/or their family members know and agree to participate in the trial.
Exclusion Criteria:
- Allergic to esketamine or midazolam;
- Patients with cardiac arrest during intubation;
- Patients with suspected increased intracranial pressure;
- bradycardia (heart rate below 50 beats/min) or atrioventricular block;
- Untreated or undertreated patients with hyperthyroidism;
- Diseases that may affect immune-related indicators, including autoimmune diseases (rheumatoid arthritis and systemic lupus erythematosus, etc.), and malignant hematological tumours (leukaemia and lymphoma, etc.);
- Received radiotherapy or chemotherapy or received immunosuppressive drug treatment within the past 30 days, or received more than 10 mg of prednisolone per day (or other hormones at the same dose) continuous treatment;
- History of solid organ or bone marrow transplantation;
- Chronic nephrosis;
- Severe chronic liver disease (child-Pugh: Grade C);
- alcohol or opioid dependence, mental illness, or severe cognitive impairment;
- Pregnant or breastfeeding;
- Patients and/or their family members refuse to participate in the trial.
Sites / Locations
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Esketamine intubation group
Conventional intubation group
Esketamine at 0.5-1.0 mg/kg BW and rocuronium bromide at 0.6 mg/kg BW was given intravenously for induction intubation. After the intubation was completed, esketamine was continuously pumped at 0.3-1.5 mg/kg/h to maintain sedation. The Richmond Agitation Sedation Scale (RASS) was used to assess the sedation of patients every 1 hour and maintains a RASS score of -2 to 0.
Midazolam at 0.1mg/kg BW, fentanyl at 1ug/kg BW, rocuronium bromide at 0.6mg/kg BW was given intravenously for induction intubation; After the intubation was completed, sufentanil at 0.1 μg/kg/h was administered for analgesia, and remazolam tosylate at an initial dose of 0.075 mg/kg/h was administered for sedation, and the dose of remazolam tosylate was adjusted according to the RASS score. The RASS score was assessed every 1 h and maintained at -2 to 0.