Etomidate Vs Ketamine For RSI In Sepsis

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These lecture analyzes the clinical outcomes of using ketamine versus etomidate as induction agents for emergency intubation in critically ill adults. A large-scale randomized controlled trial reveals that while both medications result in similar mortality rates, ketamine is associated with a significantly higher risk of cardiovascular collapse, particularly in patients with sepsis. While etomidate is traditionally criticized for causing adrenal suppression, the provided evidence suggests it may actually offer superior hemodynamic stability compared to ketamine during the procedure. Conversely, ketamine is noted for its bronchodilatory properties and lack of impact on cortisol, though its performance suffers in patients who are catecholamine-depleted. Ultimately, the research indicates that etomidate remains a reliable first-line option, challenging the recent trend of preferring ketamine for unstable patients. Physicians are encouraged to individualize drug selection based on specific patient vulnerabilities and the necessity of maintaining blood pressure.