Nov 25 2024 2 mins
Contributor: Aaron Lessen MD
Educational Pearls:
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Induction agent selection during rapid sequence intubation involves accounting for hemodynamic stability in the post-intubation setting
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Many emergency departments use ketamine or etomidate
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A recent study sought to explore the rates of post-induction hypotension of ketamine compared with propofol
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Single center retrospective cohort study of patients between 2018-2021
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Ketamine and propofol were both significantly associated with post-induction hypotension
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Ketamine adjusted odds ratio = 4.50
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Propofol adjusted odds ratio = 4.88
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50% of patients became hypotensive after induction with either propofol or ketamine
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- These findings suggest post-induction hypotension is mainly due to sympatholysis rather than the choice of agent itself
References
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Tamsett Z, Douglas N, King C, et al. Does the choice of induction agent in rapid sequence intubation in the emergency department influence the incidence of post-induction hypotension?. Emerg Med Australas. 2024;36(3):340-347. doi:10.1111/1742-6723.14355
Summarized & Edited by Jorge Chalit, OMS3
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