Comparison of Ketamine and Etomidate During Rapid Sequence Intubation in Trauma Patients
Primary Purpose
Trauma, Shock, Traumatic
Status
Terminated
Phase
Not Applicable
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Etomidate Injection 0.2 mg/kg
Ketamine injection 2 mg/kg
Sponsored by
About this trial
This is an interventional other trial for Trauma focused on measuring etomidate, ketamine, rapid sequence intubation, trauma, hemodynamics
Eligibility Criteria
Inclusion Criteria:
- age 19~70
- Shock index ≥ 0.9
- Patients who need intubation regarding to Ajou trauma center protocol
Exclusion Criteria:
- during CPR
- CPR before hospital arrival
- Severe head trauma
- Steroid intake history
Sites / Locations
- Ajou university school of medicine
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
Etomidate
Ketamine
Arm Description
The induction agent of rapid sequence intubation is etomidate. 0.2 mg/kg
The induction agent of rapid sequence intubation is ketamine. 2 mg/kg
Outcomes
Primary Outcome Measures
Systolic blood pressure difference compared with baseline after 10 minutes
Systolic blood pressure 10 minutes after induction agent injection - baseline systolic blood pressure mmHg Positive or zero value means good result. Negative value means poor result.
Secondary Outcome Measures
Intubating condition
Intubator judge intubating condition Laryngoscopy: easy / fair / difficult (difficult is the worst result) Vocal cords position: abducted / moving / closed (closed is the worst result) Reaction to insertion of the tracheal tube and cuff inflation : none / slight / vigorous (none is the worst result)
If one of category checked the worst score, it considered :clinically unacceptable".
Incidence of hypotension
If any of these are checked, define as hypotension (from injection of induction agent to 20 minutes after)
systolic pressure < 90 mmHg
systolic pressure decrease > 40% compared to baseline
Initiation of vasopressor
Vasopressor dose increase > 30% of initial vaopressor dose
Fluid or blood loading
Patient numbers (%)
Incidence of hypertension
From injection of induction agent to 20 minutes after, systolic pressure > 160 mmHg defined as hypertension
Patients numbers (%)
Full Information
NCT ID
NCT04120870
First Posted
September 26, 2019
Last Updated
February 16, 2022
Sponsor
Ajou University School of Medicine
Collaborators
Unimedics (http://unimedics.co.kr)
1. Study Identification
Unique Protocol Identification Number
NCT04120870
Brief Title
Comparison of Ketamine and Etomidate During Rapid Sequence Intubation in Trauma Patients
Official Title
Comparison of Effects on Hemodynamics Between Ketamine and Etomidate During Rapid Sequence Intubation in Trauma Patients With High Shock Index
Study Type
Interventional
2. Study Status
Record Verification Date
February 2022
Overall Recruitment Status
Terminated
Why Stopped
Due to difficulties in obtaining consent because of emergency situation
Study Start Date
October 1, 2019 (Actual)
Primary Completion Date
November 30, 2021 (Actual)
Study Completion Date
December 30, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ajou University School of Medicine
Collaborators
Unimedics (http://unimedics.co.kr)
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
In trauma patients with high shock index, the investigators compare the effects on hemodynamics between ketamine and etomidate.
Detailed Description
In trauma patients, rapid sequence intubation is recommended. The drug of choice, however, has been debated. One cohort comparative study showed ketamine had benefit in hemodynamics compared to etomidate in trauma patients. One observational study showed in high shock index patients, ketamine showed maintain systolic blood pressure. And other retrospective showed less clinical hypotension was less in ketamine. However there is no randomized controlled study comparing ketamine and etomidate in trauma patients. The purpose of this study is comparing the effects of hemodynamics between ketamine and etomidate in high shock index trauma patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Trauma, Shock, Traumatic
Keywords
etomidate, ketamine, rapid sequence intubation, trauma, hemodynamics
7. Study Design
Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
ketamine group: ketamine 2 mg/kg iv as induction agent etomidate group: etomidate 0.2 mg/kg iv as induction agent
Masking
None (Open Label)
Masking Description
open label
Allocation
Randomized
Enrollment
10 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Etomidate
Arm Type
Active Comparator
Arm Description
The induction agent of rapid sequence intubation is etomidate. 0.2 mg/kg
Arm Title
Ketamine
Arm Type
Experimental
Arm Description
The induction agent of rapid sequence intubation is ketamine. 2 mg/kg
Intervention Type
Drug
Intervention Name(s)
Etomidate Injection 0.2 mg/kg
Other Intervention Name(s)
Etomidate
Intervention Description
The induction agent of rapid sequence intubation is etomidate. 0.2 mg/kg
Intervention Type
Drug
Intervention Name(s)
Ketamine injection 2 mg/kg
Other Intervention Name(s)
Ketamine
Intervention Description
The induction agent of rapid sequence intubation is ketamine. 2 mg/kg
Primary Outcome Measure Information:
Title
Systolic blood pressure difference compared with baseline after 10 minutes
Description
Systolic blood pressure 10 minutes after induction agent injection - baseline systolic blood pressure mmHg Positive or zero value means good result. Negative value means poor result.
Time Frame
13 minutes
Secondary Outcome Measure Information:
Title
Intubating condition
Description
Intubator judge intubating condition Laryngoscopy: easy / fair / difficult (difficult is the worst result) Vocal cords position: abducted / moving / closed (closed is the worst result) Reaction to insertion of the tracheal tube and cuff inflation : none / slight / vigorous (none is the worst result)
If one of category checked the worst score, it considered :clinically unacceptable".
Time Frame
5 minutes
Title
Incidence of hypotension
Description
If any of these are checked, define as hypotension (from injection of induction agent to 20 minutes after)
systolic pressure < 90 mmHg
systolic pressure decrease > 40% compared to baseline
Initiation of vasopressor
Vasopressor dose increase > 30% of initial vaopressor dose
Fluid or blood loading
Patient numbers (%)
Time Frame
25 minutes
Title
Incidence of hypertension
Description
From injection of induction agent to 20 minutes after, systolic pressure > 160 mmHg defined as hypertension
Patients numbers (%)
Time Frame
25 miinutes
10. Eligibility
Sex
All
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
age 19~70
Shock index ≥ 0.9
Patients who need intubation regarding to Ajou trauma center protocol
Exclusion Criteria:
during CPR
CPR before hospital arrival
Severe head trauma
Steroid intake history
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
In Kyong Yi, MD
Organizational Affiliation
Ajou University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ajou university school of medicine
City
Suwon
State/Province
Gyeonggi-do
ZIP/Postal Code
16499
Country
Korea, Republic of
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
If there is a reasonable request, we can share the data personally.
Learn more about this trial
Comparison of Ketamine and Etomidate During Rapid Sequence Intubation in Trauma Patients
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