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Signa vitae : journal for intesive care and emergency medicine, Vol. Volume 14 No. 2, 2018.

Original scientific paper

https://doi.org/10.22514/SV142.102018.3

Ketamine use for endotracheal intubation in severe sepsis and septic shock

Tae Gun Shin orcid id orcid.org/0000-0001-9657-1040 ; Department of Emergency Medicine Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon-ro, Gangnam-gu, Seoul, Korea
SEOK WOO Jo
SUNG YEON HWANG
IK JOON JO
TAE RIM LEE
HEE YOON
WON CHUL CHA
MIN SEOB SIM

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Abstract

Objective. We conducted this study to evaluate the clinical outcomes of patients with severe sepsis and septic shock who were treated with ketamine for endotracheal intubation.
Methods. A single-center, retrospective study was carried out to compare the outcomes of patients with severe sepsis and septic shock who received a ketamine or non-ketamine agent for rapid sequence
intubation (RSI). We analyzed the sepsis registry for adult patients who presented to the emergency department (ED), met the criteria for severe sepsis or septic shock, and underwent endotracheal intubation
between August 2008 and March 2014. Te primary outcome was 28-day mortality. We performed a multivariable logistic regression analysis to assess the association between ketamine use for intubation and
28-day mortality.
Results. In all, 170 patients were intubated
during the study period. Of the eligible
patients, 95 received ketamine and 75 received a non-ketamine agent. Te 28-day mortality of the ketamine group was not
signifcantly diferent from that of the nonketamine group (38% vs. 40%, respectively,P=0.78). Te unadjusted odds ratio (OR)
of ketamine use for 28-day mortality was 0.92 (95% CI: 0.49–1.70, P=0.78). Te association remained insignifcant afer adjusting for age, gender, malignancy, initial lactate level on ED admission, time to frst
antibiotic administration, Acute Physiology and Chronic Health Evaluation II score on admission day, and propensity score regarding ketamine use (adjusted OR: 1.09; 95% confdence interval [CI]: 0.49–2.40;P=0.84). Initial serum lactate on ED admission was the only signifcant predictive factor of 28-day mortality (adjusted OR:
1.23; 95% CI: 1.10–1.38; P<0.01). Conclusions. For patients with severe sepsis and septic shock who were intubated using RSI, we found no signifcant diference in 28-day mortality between those who received ketamine as a sedative agent and those who received alternative sedatives.

Keywords

sepsis; ketamine; intubation; mortality

Hrčak ID:

217588

URI

https://hrcak.srce.hr/217588

Publication date:

1.11.2018.

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