Effects of etomidate and ketamine on blood pressure after intubation in patients with ICU sepsis

Kan Jing-xiang; Zhu Hai-ying; Zhao Guo-qin; Liu Zhong-kai

doi:10.3969/j.issn.1002-1949.2018.02.019

Abstract：Objective To compare the incidence of hypotension after intubation induced by etomidate or ketamine in ICU patients with sepsis. Methods A retrospective study was conducted in this study. The clinical data of 464 patients with sepsis treated with ICU in our hospital were selected. All patients were intubated for the first time and induced with ketamine or etomidate. According to the difference inducer,the patients were divided into the etomidate group and the ketamine group. Tendency scores were used to adjust baseline differences between the two groups. The mean arterial pressure (MAP) values of the patients were recorded before intubation,0~1 h,1~6 h,6~12 h and 12~24 h after intubation. The incidence of clinical hypotension was compared between the two groups after 24 hours of intubation. Results After adjustment,135 patients were enrolled in the etomidate group and the ketamine group. Compared with the ketamine group, the incidence of hypotension in the etomidate group was significantly higher[72.6% (98/135) vs. 51.1% (69/135), χ2=13.201, P<0.001]. The MAP values of 6~12 h[(65.98 ± 13.26) mm Hg vs. (69.34 ± 16.95) mm Hg, t=2.246, P=0.026] and 12~24 h[(63.90 ± 13.35) mm Hg vs. (68.47 ± 15.71)mm Hg,t=2.576,P=0.011] in the etomidate group were significantly lower than those in the ketamine group, the difference was statistically significant. Conclusion Inoculation with etomidate can significantly increase the incidence of clinical hypotension in patients with sepsis compared with ketamine. And ketamine has a positive effect on hemodynamics,is a substitute for etomidate for sepsis patients with tracheal intubation agent.