Journal of Molecular and Pharmaceutical Sciences
Volume 5, Numéro 1, Pages 10-18
2026-06-30
Ketamine Versus Etomidate For Rapid Sequence Induction: Current Data In Emergency Medicine And Critical Care
Authors : Derbal Saïd . Belafdal Imen .
Abstract
To evaluate current clinical evidence comparing ketamine and etomidate in rapid sequence induction (RSI) and critical care, focusing on survival, haemodynamic stability and endocrine complications. Etomidate provides immediate haemodynamic stability, but its use in critically ill patients is associated with systematic adrenal suppression and, in some cohorts, increased hospital mortality. Ketamine does not appear to increase the risk of post-intubation hypotension compared to etomidate when the shock index is taken into account and offers a protective advantage against long-term post-traumatic stress. In paediatrics, both agents have a comparable safety profile. Although intubation success rates are similar, ketamine is the agent of choice for sepsis and trauma due to its endocrine safety, while etomidate remains an option for neurosurgery subject to careful selection.
Keywords
Ketamine ; Etomidate ; Anaesthesia ; Critical care ; Adrenal suppression ; Mortality ; Haemodynamic instability
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