• Megan A Van Berkel, Matthew C Exline, Kari M Cape, Lindsay P Ryder, Gary Phillips, Naeem A Ali, and Bruce A Doepker.
• Department of Pharmacy, Methodist LeBohneur Healthcare- University Hospital, 1265 Union Ave., Memphis, TN 38104. Electronic address: Megan.VanBerkel@mlh.org.
• J Crit Care. 2017 Apr 1; 38: 209-214.

PurposeThis study compared the incidence of clinical hypotension between ketamine and etomidate within a 24 hour period following endotracheal intubation.Materials And MethodsThis single-center, retrospective propensity-matched cohort study included septic patients admitted to our medical intensive care unit who received either etomidate or ketamine for intubation. Clinical hypotension was defined as any one of the following: mean arterial pressure (MAP) decrease >40% compared to baseline and MAP <70 mmHg, MAP <60 mmHg, initiation of a vasopressor, or increase to >30% of the initial vasopressor dose.ResultsPatients were matched based on propensity scores determined by demographics and baseline characteristics. A total of 384 (200 etomidate and 184 ketamine) patients were included for analysis with 230 patients (115 in each group) matched. Clinical hypotension was less prevalent in patients who received ketamine as compared to etomidate [51.3% vs. 73% (odds ratio=0.39, 95% confidence interval=0.22-0.67, P=.001]. The etomidate group experienced significantly lower MAPs at time periods 6.1-12 hours (65.1 mmHg vs. 69.3 mmHg, P=.01) and 12.1-24 hours (63.9 mmHg vs. 68.4 mmHg, P=.003).ConclusionsKetamine was associated with a lower incidence of clinical hypotension within the 24 hour period following endotracheal intubation in septic patients.Copyright © 2016 Elsevier Inc. All rights reserved.

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