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INTRODUCTION

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3/5/2026 Anesthesiology Journal Club - Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults.

QUIZ

EVALUATION

CERTIFICATE

INTRODUCTION

Credit Hours: 0.75

Target Audience:

Anesthesiologists and anesthesiologists-in-training and other anesthesia professionals, nurse anesthetists and anesthesia assistants.

Educational Objectives:

Upon completion of this activity, participants should be able to:

  • Analyze the current randomized trial and meta-analysis evidence comparing etomidate and ketamine for induction in critically ill adults, with attention to mortality, hemodynamic outcomes, and adrenal suppression.
  • Compare the physiologic effects, potential risks, and benefits of etomidate versus ketamine in hemodynamically unstable and septic patients requiring emergency intubation.
  • Apply study findings and identified limitations to inform evidence-based selection of induction agents in non-trauma, critically ill ED and ICU patients. 

Suggested Additional Reading:

  1. Knack SKS, Prekker ME, Moore JC, Klein LR, Atkins AH, Miner JR, Driver BE. The Effect of Ketamine Versus Etomidate for Rapid Sequence Intubation on Maximum Sequential Organ Failure Assessment Score: A Randomized Clinical Trial. J Emerg Med. 2023 Nov;65(5):e371-e382. doi: 10.1016/j.jemermed.2023.06.009. Epub 2023 Jun 20. PMID: 37741737.
  2. Bandyopadhyay A, Haldar P, Sawhney C, Singh A. Efficacy of ketamine versus etomidate for rapid sequence intubation of critically ill patients in terms of mortality and success rate: a systematic review and meta-analysis of randomized controlled trials. Clin Exp Emerg Med. 2025 Dec;12(4):331-341. doi: 10.15441/ceem.24.363. Epub 2025 Aug 13. PMID: 40803356; PMCID: PMC12824542.
  3. Wunsch H, Bosch NA, Law AC, Vail EA, Hua M, Shen BH, Lindenauer PK, Juurlink DN, Walkey AJ, Gershengorn HB. Evaluation of Etomidate Use and Association with Mortality Compared with Ketamine among Critically Ill Patients. Am J Respir Crit Care Med. 2024 Nov 15;210(10):1243-1251. doi: 10.1164/rccm.202404-0813OC. PMID: 39173173.

Authors:
Adam Watkins, MD — PGY-2 Resident, UPMC Department of Anesthesiology & Perioperative Medicine
No relationships with industry relevant to the content of this educational activity have been disclosed.
Daniel Ratushnyak MD — PGY-2 Resident, UPMC Department of Anesthesiology & Perioperative Medicine
No relationships with industry relevant to the content of this educational activity have been disclosed.
James Brown, MD — PGY-2 Resident, UPMC Department of Anesthesiology & Perioperative Medicine
No relationships with industry relevant to the content of this educational activity have been disclosed.
Stephen McHugh, MD, FASA — Assistant Professor, Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine
No members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships with any companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
No other members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships with any companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

The University of Pittsburgh School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. The University of Pittsburgh School of Medicine designates this enduring material activity for a maximum of 0.75 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity.

Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

The University of Pittsburgh is an affirmative action, equal opportunity institution.