The Impact of Propofol and Ketamine on Cardiovascular Collapse During Induction for Intubation

Kocaeli City Hospital

Status

Enrolling

Conditions

Anaesthetic Complication Cardiac

Cardiovascular Collapse

Intubation Complication

Treatments

Other: propofol

Other: ketamine

Study type

Observational

Funder types

Other

Identifiers

NCT06750939

ksh.Oemgin.001

Details and patient eligibility

About

This prospective observational study evaluates the impact of propofol and ketamine on the risk of cardiovascular collapse during induction for endotracheal intubation in critically ill patients. Induction agents play a crucial role in managing hemodynamic stability, particularly in this vulnerable population. Propofol, known for its vasodilatory and myocardial depressant effects, has been associated with significant hypotension during induction. Conversely, ketamine, with its sympathomimetic properties, is often considered a safer alternative for hemodynamic stability.

In addition to comparing the incidence of cardiovascular collapse-defined as severe hypotension or cardiac arrest-this study examines the relationship between these induction agents and shock indices, including systolic shock index, diastolic shock index, age-adjusted shock index, and modified shock index. These parameters will provide a more detailed understanding of the hemodynamic effects of each agent and their clinical implications. The findings aim to guide induction agent selection to optimize outcomes in critically ill patients.

Enrollment

128 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients aged over 18 years
Patients admitted to the intensive care unit (ICU) who undergo endotracheal intubation during their ICU stay will be included.

Exclusion criteria

Patients who did not provide consent to participate in the study
Patients intubated due to cardiac arrest
Patients intubated outside the intensive care unit

Trial design

128 participants in 2 patient groups

Cardiovascular collapse

Description:

"- At least one documented episode of SpO₂ \< 80%, ensuring accuracy of measurement. * At least one episode of systolic arterial blood pressure (SAB) \< 65 mmHg. * SAB \< 90 mmHg sustained for a duration of 30 minutes. * Initiation of norepinephrine therapy. * Escalation of pre-existing norepinephrine infusion dose. * Administration of \>15 mL/kg crystalloid fluids to achieve SAB \> 90 mmHg. * Occurrence of cardiac arrest." The occurrence of any of the above-mentioned events within the first 30 minutes following the initiation of the intervention will be considered as cardiovascular collapse.

Treatment:

Other: ketamine

Other: propofol

No Cardiovascular collapse

Treatment:

Other: ketamine

Other: propofol