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Study supports use of ketamine


Ketamine could be a safe alternative to the standard drug used when inserting a tube into the airways of critically ill patients, research suggests.

A study by Professor Frederic Adnet of the Hopitaux de Paris, France, looked at using ketamine instead of etomidate after previous data suggested the conventional sedative could be associated with increased mortality in patients with sepsis.

The research, published online in the Lancet, looked at 655 patients from 12 emergency departments and 65 intensive care units in France who needed emergency intubation.

Patients were split into two groups: one receiving 0.3 mg/kg of etomidate; the other prescribed 2mg/kg of ketamine.

When comparing the maximum score of a sequential organ failure assessment, scientists found they did not differ significantly between the two groups.

However, adrenal insufficiency – a known side-effect associated with etomidate – occurred in 86% of patients given etomidate, compared with just 48% of those given ketamine.

The authors put the adrenal insufficiency seen in the ketamine group down to causes other than the sedative agent.

They concluded: “Our results show that ketamine is a safe and valuable alternative to etomidate for endotracheal intubation in critically ill patients, and should be considered in those with sepsis.”

Copyright Press Association 2009

The Lancet

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