pem pearl: ketamine for intubations

In this study 10,750 intubations in children 0-17 in 40 PICU were studied, and ketamine was compared to other induction agents. Of the 10,750 intubations, 32% had ketamine as the induction agent. The most common diagnosis associated with ketamine was sepsis or shock and the odds ratio was 0.74 with 95% CI, (0.58-0.95). The interesting thing was the interaction between ketamine use and indication for shock was also studied and not significant. This suggests that ketamine itself lowers the risk for an adverse outcome and should be the first line agent in the hemodynamically unstable pediatric patients

​Bottom line: This study shows that ketamine has fewer adverse events for tracheal intubations than other agents.