Health Condition 1: J960- Acute respiratory failure
Conditions
Interventions
Intervention1: Ketamine and midazolam combination as induction regimen prior to endotracheal intubation: Critically ill children requiring endotracheal intubation will receive a combination of ketamin
Sponsors
None
Eligibility
Inclusion criteria
Inclusion criteria: Critically ill children, age 2 month (corrected age) - 18 years admitted in wards, HDU and PICU - With one or more organ dysfunction AND - Requiring tracheal intubation - Patients who have already been enrolled before but are meeting inclusion criteria at a different time point and not on any sedative- analgesics at the time of current enrolment.
Exclusion criteria
Exclusion criteria: - Known hypersensitivity to Ketamine - Hypertensive urgency and emergency - Craniofacial malformation - Mucopolysaccaridoses/ mucolipidoses - Pierre robin sequence - Downââ?¬•s syndrome - History of face/neck trauma/burns/radiation - Neck masses - Patients presenting with cardiopulmonary arrest or being intubated for cardiopulmonary arrest
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of adverse hemodynamic events defined as bradycardia defined as heart rate less than 60 minutes or hypotension requiring fluid bolus/inotrope or fall in systolic blood pressure by 30% of pre intubation value or increase in inotrope/vasopressor requirement by 30% from pre intubation requirement or cardiac arrest with or without ROSC from the beginning of induction up to 30 minutes after intubationTimepoint: Before intubation and at o,1,3,5,7,10,15,20,25 and 30 minutes after endotracheal intubation | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of other Tracheal Intubation associated Adverse Events (TIAEs) defined as trauma, emesis with or without aspiration, endobronchial/esophageal intubation, dysrhythmia, laryngospasm, pneumothoraxTimepoint: Trauma and laryngospasm will be assessed at the time of intubation. Dysrhythmias and emesis will be assessed at baseline and at 0,1,3,5,7,10,15,20,25,30 minutes after endotracheal intubation Endobronchial intubation and pneumothorax will be confirmed by chest Xray after endotracheal intubation.;Proportion of encounters requiring repeat doses of sedatives to achieve adequate sedation (State 1/2 as assessed using Pediatric Sedation State Scale) Timepoint: At the time of intubation;Proportion of the encounters requiring neuromuscular blocker useTimepoint: At the time of intubation | — |
Countries
India
Contacts
Public ContactDr Jhuma Sankar
All India Institute of Medical Sciences, New Delhi
Outcome results
None listed