search
Back to results

Esketamine Induction Intubation in ICU Patients.

Primary Purpose

Critically Ill Patients

Status
Recruiting
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Esketamine Hydrochloride 28 Mg in 0.2 mL NASAL SOLUTION [Spravato]
midazolam, fentanyl
Sponsored by
Wuhan Union Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Critically Ill Patients focused on measuring Esketamine, Tracheal intubation, Hemodynamics

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

Arm Type

Experimental

Placebo Comparator

Arm Label

Esketamine intubation group

Conventional intubation group

Arm Description

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.

Outcomes

Primary Outcome Measures

Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Level of heart rate and respiratory rate
Heart rate and respiratory rate
Level of heart rate and respiratory rate
Heart rate and respiratory rate
Level of heart rate and respiratory rate
Heart rate and respiratory rate
Level of heart rate and respiratory rate
Heart rate and respiratory rate
Level of heart rate and respiratory rate
Heart rate and respiratory rate
Level of heart rate and respiratory rate
Heart rate and respiratory rate
Level of heart rate and respiratory rate
Heart rate and respiratory rate
Level of heart rate and respiratory rate
Heart rate and respiratory rate
Level of pulse oximetry
Pulse oximetry
Level of pulse oximetry
Pulse oximetry
Level of pulse oximetry
Pulse oximetry
Level of pulse oximetry
Pulse oximetry
Level of pulse oximetry
Pulse oximetry
Level of pulse oximetry
Pulse oximetry
Level of pulse oximetry
Pulse oximetry
Level of pulse oximetry
Pulse oximetry

Secondary Outcome Measures

Doses of epinephrine and norepinephrine
Epinephrine and norepinephrine doses
Doses of epinephrine and norepinephrine
Epinephrine and norepinephrine doses
Plasma cytokine levels
IL-2、IL-4、IL-6、IL-10、IL-17A、IFN-γ、TNF-α
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
0-67, higher scores correspond to more severe disease and a higher risk of death
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
0-67, higher scores correspond to more severe disease and a higher risk of death
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
0-67, higher scores correspond to more severe disease and a higher risk of death
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
0-67, higher scores correspond to more severe disease and a higher risk of death
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
0-67, higher scores correspond to more severe disease and a higher risk of death
Sequential organ failure assessment (SOFA) score
0-43, higher scores correspond to more severe disease
Sequential organ failure assessment (SOFA) score
0-43, higher scores correspond to more severe disease
Sequential organ failure assessment (SOFA) score
0-43, higher scores correspond to more severe disease
Sequential organ failure assessment (SOFA) score
0-43, higher scores correspond to more severe disease
Sequential organ failure assessment (SOFA) score
0-43, higher scores correspond to more severe disease
Hamilton Anxiety Scale (HAMA) Score
0-29,higher scores correspond to more severe anxiety
Hamilton Depression Scale (HAMD) Score
0-35,higher scores correspond to more severe depression
The number of intubation attempts
Intubation times
Mechanical ventilation-free time
Time to weaning from invasive mechanical ventilation
28-day ICU and in-hospital mortality
Death within 28 days after hospitalization or ICU stay
90-day readmission rates
Hospitalized again within 90 days after discharge from hospital.

Full Information

First Posted
July 14, 2022
Last Updated
May 8, 2023
Sponsor
Wuhan Union Hospital, China
search

1. Study Identification

Unique Protocol Identification Number
NCT05464979
Brief Title
Esketamine Induction Intubation in ICU Patients.
Official Title
Clinical Effects of Esketamine Induction Intubation Versus Conventional Induction Intubation in ICU Patients: a Single-center Randomized Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 1, 2022 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
June 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wuhan Union Hospital, China

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Intubation in the intensive care unit (ICU) is usually an emergency. Pathophysiological changes such as shock, respiratory failure, and metabolic acidosis in critically ill patients can significantly increase the incidence of adverse events during intubation. Studies have shown that esketamine has no significant effect on body metabolism, endocrine system, liver, kidney, intestinal function and coagulation function. In terms of drug metabolism, esketamine has high bioavailability, short half-life, faster and more comfortable recovery of patients, and not only has the advantage of providing stable hemodynamics during endotracheal intubation, but also counteracts the respiratory depression caused by opioids. In addition, esketamine has antidepressant and anti-inflammatory properties. The investigators also found that combined prophylactic and therapeutic use of esketamine could attenuate systemic inflammation and inflammatory multi-organ injury in mice after CLP-induced lethal sepsis. This project aims to study the clinical effect of esketamine induction intubation and conventional induction intubation in ICU patients.
Detailed Description
Esketamine is the S-enantiomer of ketamine and has been approved for clinical use by the National Medical Products Administration (NMPA) in 2019. Studies have shown that esketamine has no significant effect on metabolism, endocrine system, liver, kidney, intestinal function and coagulation function. It is mainly used in combination with sedatives (such as propofol, etc.) or alone to induce and implement general anesthesia. The phase III clinical study on the application of esketamine in the induction and maintenance of general anesthesia in laparoscopic surgery showed that the recovery time of the esketamine group was significantly shorter than that of the ketamine group when the same clinical anesthesia effect was achieved. Esketamine has the effect of dissociative anesthesia, which can maintain better spontaneous breathing of patients while satisfying outpatient examinations or operations, and this feature helps maintain circulatory stability, especially in patients with shock. Esketamine has sympathomimetic properties. In patients with potentially unstable cardiac disease (eg, septic cardiomyopathy), esketamine is the preferred choice for induction of anesthesia, especially in combination with midazolam. Esketamine is also the preferred choice for anesthesia induction in patients with bronchospasm, which can protect patients from bronchospasm during induction. Studies have found that esketamine has antidepressant and anti-inflammatory effects in addition to its analgesic, sedative and anesthetic effects. Clinical studies have shown that esketamine (0.25 mg/kg, 40 min infusion time) can rapidly improve the depressive symptoms of patients with treatment-resistant depression. The antidepressant effects of esketamine may be closely related to its anti-inflammatory effect. During cardiopulmonary bypass surgery, anesthesia induction was supplemented with 1-3 mg/kg esketamine, anesthesia maintenance was supplemented with 2-3 mg/kg/h esketamine, anesthesia maintenance time was 283 minutes, the total amount of esketamine was 1580mg on average. Esketamine decreased plasma levels of IL-6 (6 h after opening the aorta) and IL-8 (1 and 6 h after opening the aorta) and increased plasma levels of IL-10 (1 h after opening the aorta). In the investigators' preliminary study on the role of esketamine in systemic inflammation induced by lipopolysaccharide (LPS), the investigators found that in systemic LPS (5 mg/kg)-induced systemic inflammation model, esketamine (10 mg/kg, IP) was administrated twice 24 hours before LPS administration and 10 minutes after LPS administration. The plasma levels of IL-6, IL-17A and interferon γ (IFN-γ) were significantly decreased 24 h after LPS administration in mice. However, the efficacy and safety of esketamine for tracheal intubation in ICU patients is still unclear, and no relevant clinical studies have been reported. The investigators will include adult patients subjected to tracheal intubation in the ICU strictly according to the inclusion and exclusion criteria to investigate the efficacy and safety of esketamine for tracheal intubation in ICU patients. Enrolled patients were randomly assigned to two groups: the esketamine intubation group and the conventional intubation group. In esketamine 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. In conventional intubation group, 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. Five tubes of venous blood were collected and sent to the laboratory and immunology department of Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, before intubation and 1, 2, 3 and 7 days after intubation, and five tests including blood routine, coagulation, liver function, kidney function, electrolytes, C-reactive protein, myocardial enzyme, BNP, lymphocyte subsets and cytokines were performed. A tube of arterial blood was collected before intubation and 1, 2, 3 and 7 days after intubation to detect arterial blood gas in the ICU. If the adverse events of esketamine appear during the study, patients or authorized client withdraw from the study actively, or drugs that seriously affect systemic inflammation and immune function (such as non-steroidal anti-inflammatory drugs, immunosuppressants, immunoenhancers, high doses of hormones (more than 10mg prednisolone per day or equivalent dose of other hormones, etc.) were used in clinical treatment, the study will be terminated. In this study, adverse reactions were evaluated daily after inclusion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Critically Ill Patients
Keywords
Esketamine, Tracheal intubation, Hemodynamics

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Esketamine intubation group
Arm Type
Experimental
Arm Description
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.
Arm Title
Conventional intubation group
Arm Type
Placebo Comparator
Arm Description
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.
Intervention Type
Drug
Intervention Name(s)
Esketamine Hydrochloride 28 Mg in 0.2 mL NASAL SOLUTION [Spravato]
Other Intervention Name(s)
(S)-ketamine
Intervention Description
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.
Intervention Type
Drug
Intervention Name(s)
midazolam, fentanyl
Intervention Description
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.
Primary Outcome Measure Information:
Title
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Description
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Time Frame
5 minutes before induction
Title
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Description
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Time Frame
0 hour after induction
Title
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Description
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Time Frame
0 hour after intubation
Title
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Description
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Time Frame
1 minute after intubation
Title
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Description
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Time Frame
5 minutes after intubation
Title
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Description
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Time Frame
10 minutes after intubation
Title
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Description
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Time Frame
30 minutes after intubation
Title
Level of systolic blood pressure, diastolic blood pressure and mean arterial pressure
Description
Systolic blood pressure, diastolic blood pressure and mean arterial pressure
Time Frame
60 minutes after intubation
Title
Level of heart rate and respiratory rate
Description
Heart rate and respiratory rate
Time Frame
5 minutes before induction
Title
Level of heart rate and respiratory rate
Description
Heart rate and respiratory rate
Time Frame
0 hour after induction
Title
Level of heart rate and respiratory rate
Description
Heart rate and respiratory rate
Time Frame
0 hour after intubation
Title
Level of heart rate and respiratory rate
Description
Heart rate and respiratory rate
Time Frame
1 minute after intubation
Title
Level of heart rate and respiratory rate
Description
Heart rate and respiratory rate
Time Frame
5 minutes after intubation
Title
Level of heart rate and respiratory rate
Description
Heart rate and respiratory rate
Time Frame
10 minutes after intubation
Title
Level of heart rate and respiratory rate
Description
Heart rate and respiratory rate
Time Frame
30 minutes after intubation
Title
Level of heart rate and respiratory rate
Description
Heart rate and respiratory rate
Time Frame
60 minutes after intubation
Title
Level of pulse oximetry
Description
Pulse oximetry
Time Frame
5 minutes before induction
Title
Level of pulse oximetry
Description
Pulse oximetry
Time Frame
0 hour after induction
Title
Level of pulse oximetry
Description
Pulse oximetry
Time Frame
0 hour after intubation
Title
Level of pulse oximetry
Description
Pulse oximetry
Time Frame
1 minute after intubation
Title
Level of pulse oximetry
Description
Pulse oximetry
Time Frame
5 minutes after intubation
Title
Level of pulse oximetry
Description
Pulse oximetry
Time Frame
10 minutes after intubation
Title
Level of pulse oximetry
Description
Pulse oximetry
Time Frame
30 minutes after intubation
Title
Level of pulse oximetry
Description
Pulse oximetry
Time Frame
60 minutes after intubation
Secondary Outcome Measure Information:
Title
Doses of epinephrine and norepinephrine
Description
Epinephrine and norepinephrine doses
Time Frame
At 1 hour after intubation
Title
Doses of epinephrine and norepinephrine
Description
Epinephrine and norepinephrine doses
Time Frame
At 24 hours after intubation
Title
Plasma cytokine levels
Description
IL-2、IL-4、IL-6、IL-10、IL-17A、IFN-γ、TNF-α
Time Frame
On day 3 after intubation
Title
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
Description
0-67, higher scores correspond to more severe disease and a higher risk of death
Time Frame
0 hour after study inclusion
Title
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
Description
0-67, higher scores correspond to more severe disease and a higher risk of death
Time Frame
1 day after intubation
Title
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
Description
0-67, higher scores correspond to more severe disease and a higher risk of death
Time Frame
2 days after intubation
Title
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
Description
0-67, higher scores correspond to more severe disease and a higher risk of death
Time Frame
3 days after intubation
Title
Acute physiology and chronic health evaluation (APACHE) Ⅱ score
Description
0-67, higher scores correspond to more severe disease and a higher risk of death
Time Frame
7 days after intubation
Title
Sequential organ failure assessment (SOFA) score
Description
0-43, higher scores correspond to more severe disease
Time Frame
0 hour after study inclusion
Title
Sequential organ failure assessment (SOFA) score
Description
0-43, higher scores correspond to more severe disease
Time Frame
1 day after intubation
Title
Sequential organ failure assessment (SOFA) score
Description
0-43, higher scores correspond to more severe disease
Time Frame
2 days after intubation
Title
Sequential organ failure assessment (SOFA) score
Description
0-43, higher scores correspond to more severe disease
Time Frame
3 days after intubation
Title
Sequential organ failure assessment (SOFA) score
Description
0-43, higher scores correspond to more severe disease
Time Frame
7 days after intubation
Title
Hamilton Anxiety Scale (HAMA) Score
Description
0-29,higher scores correspond to more severe anxiety
Time Frame
1 day after extubation
Title
Hamilton Depression Scale (HAMD) Score
Description
0-35,higher scores correspond to more severe depression
Time Frame
1 day after extubation
Title
The number of intubation attempts
Description
Intubation times
Time Frame
At intubation procedure
Title
Mechanical ventilation-free time
Description
Time to weaning from invasive mechanical ventilation
Time Frame
7 days of after inclusion
Title
28-day ICU and in-hospital mortality
Description
Death within 28 days after hospitalization or ICU stay
Time Frame
Up to 28 days after inclusion
Title
90-day readmission rates
Description
Hospitalized again within 90 days after discharge from hospital.
Time Frame
Up to 90 days after discharge from hospital

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
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.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jiancheng Zhang, MD, PhD
Phone
+8613554105815
Email
zhjcheng1@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jiancheng Zhang, MD, PhD
Organizational Affiliation
Wuhan Union Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jiancheng Zhang, Dr.
Phone
+8613554105815
Email
zhjcheng1@126.com
First Name & Middle Initial & Last Name & Degree
Jiancheng Zhang, Dr.

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
After publication, the data supporting the findings of this study can be provided by the corresponding author upon reasonable request. Participant data without names and identifiers can be provided by the corresponding author and the Wuhan Union Hospital after approval. The research team will provide an email address for communication purposes once approval is obtained regarding sharing the data with others. The proposal with detailed description of the study objectives and statistical analysis plan will be needed for evaluation of the purpose for the data request. Additional materials may also be required during the process of evaluation.
IPD Sharing Time Frame
Six months after publication.
IPD Sharing Access Criteria
Upon reasonable request.

Learn more about this trial

Esketamine Induction Intubation in ICU Patients.

We'll reach out to this number within 24 hrs