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Original Research

Open Access

Ketamine use for endotracheal intubation in severe sepsis and septic shock

  • SEOK WOO JO1
  • SUNG YEON HWANG1
  • IK JOON JO1
  • TAE RIM LEE1
  • HEE YOON1
  • WON CHUL CHA1
  • MIN SEOB SIM1
  • TAE GUN SHIN1

1Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul

DOI: 10.22514/SV142.102018.3 Vol.14,Issue 2,November 2018 pp.24-30

Published: 02 November 2018

*Corresponding Author(s): TAE GUN SHIN E-mail: tackles@naver.com

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 endotra-cheal intubation.

Methods. A single-center, retrospective study was carried out to compare the out-comes 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. The primary outcome was 28-day mortal-ity. 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 re-ceived a non-ketamine agent. The 28-day mortality of the ketamine group was not significantly different from that of the non-ketamine group (38% vs. 40%, respectively, P=0.78). The unadjusted odds ratio (OR) of ketamine use for 28-day mortality was 0.92 (95% CI: 0.49–1.70, P=0.78). The as-sociation remained insignificant after ad-justing for age, gender, malignancy, initial lactate level on ED admission, time to first antibiotic administration, Acute Physiolo-gy and Chronic Health Evaluation II score on admission day, and propensity score re-garding ketamine use (adjusted OR: 1.09; 95% confidence interval [CI]: 0.49–2.40;P=0.84). Initial serum lactate on ED ad-mission was the only significant predictive factor of 28-day mortality (adjusted OR: 1.23; 95% CI: 1.10–1.38; P<0.01). Conclusions. For patients with severe sep-sis and septic shock who were intubated using RSI, we found no significant differ-ence in 28-day mortality between those who received ketamine as a sedative agent and those who received alternative seda-tives.


Keywords

sepsis, ketamine, intubation, mortality  

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SEOK WOO JO,SUNG YEON HWANG,IK JOON JO,TAE RIM LEE,HEE YOON,WON CHUL CHA,MIN SEOB SIM,TAE GUN SHIN. Ketamine use for endotracheal intubation in severe sepsis and septic shock. Signa Vitae. 2018. 14(2);24-30.

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