None listed
Conditions
Brief summary
This retrospective cohort study compares ketamine- versus propofol-based induction for emergency intubation in critically ill adults. We will analyse Monash Health ICU data (2018-24) using causal inference methods. Primary outcome is hospital mortality; secondary outcome is a composite of haemodynamic collapse or severe hypoxaemia within 30 minutes. We hypothesise ketamine is associated with lower peri-intubation complications and improved survival.
Interventions
Brief description of the exposure:
Ketamine given at the time of emergency endotracheal intubation as the principal sedative–hypnotic induction agent (rapid-sequence induction), with other co-induction medications (e.g., opioids, neuromuscular blockade) permitted. Cases where both ketamine and propofol are used as mixed induction (“ketofol”) are excluded from the primary analysis.
What is involved for participants:
This is a retrospective study using routinely collected, de-identified clinical
Brief description of the exposure: Ketamine given at the time of emergency endotracheal intubation as the principal sedative–hypnotic induction agent (rapid-sequence induction), with other co-induction medications (e.g., opioids, neuromuscular blockade) permitted. Cases where both ketamine and propofol are used as mixed induction (“ketofol”) are excluded from the primary analysis. What is involved for participants: This is a retrospective study using routinely collected, de-identified clinical data (EMR, intubation records and clinical information systems). There are no questionnaires, no additional samples, and no participant contact. A waiver of consent applies due to retrospective de-identified data. Duration of observation: Time zero is the timestamp of induction drug administration. Participants are observed for (i) 0–30 minutes post-intubation for peri-intubation physiological endpoints, and (ii) from induction until death, hospital discharge, or 28 days, whichever occurs first, for the primary outcome. Study period : Jan 2019-Jan 2024
Sponsors
Monash Health - ICU Research Team - Rafael von Hellmann
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Adults = greater than or equal to 18 years • Emergency endotracheal intubation (ED, ward or ICU) • Non-elective, non-OR • Admitted to Monash ICU afterwards
Exclusion criteria
Elective Intubations Not admitted to Monash Health ICU's
Outcome results
None listed