Esketamine Induction Intubation in ICU Patients.

• Status: Not yet recruiting
• Trial end date: 2024-06-30
• Target enrollment: 0
• Participant gender: All

Summary

Intubation in the intensive care unit (ICU) is usually an emergency. Pathophysiological changes such as shock, respiratory failure, and metabolic acidosis in critically ill patients can significantly increase the incidence of adverse events during intubation.

Studies have shown that esketamine has no significant effect on body metabolism, endocrine system, liver, kidney, intestinal function and coagulation function. In terms of drug metabolism, esketamine has high bioavailability, short half-life, faster and more comfortable recovery of patients, and not only has the advantage of providing stable hemodynamics during endotracheal intubation, but also counteracts the respiratory depression caused by opioids. In addition, esketamine has antidepressant and anti-inflammatory properties. The investigators also found that combined prophylactic and therapeutic use of esketamine could attenuate systemic inflammation and inflammatory multi-organ injury in mice after CLP-induced lethal sepsis.

This project aims to study the clinical effect of esketamine induction intubation and conventional induction intubation in ICU patients.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Wuhan Union Hospital, China
• Treatments: Esketamine; Fentanyl; Ketamine; Midazolam

Criteria

Inclusion Criteria:

• Patients aged 18-80 years old without restriction of gender, race, religion, creed or nationality;

• No sedative drugs with elimination half-life were used before inclusion in the study;

• Patients and/or their family members know and agree to participate in the trial.

Exclusion Criteria:

• Allergic to esketamine or midazolam;

• Patients with cardiac arrest during intubation;

• Patients with suspected increased intracranial pressure;

• bradycardia (heart rate below 50 beats/min) or atrioventricular block;

• Untreated or undertreated patients with hyperthyroidism;

• Diseases that may affect immune-related indicators, including autoimmune diseases (rheumatoid arthritis and systemic lupus erythematosus, etc.), and malignant hematological tumours (leukaemia and lymphoma, etc.);

• Received radiotherapy or chemotherapy or received immunosuppressive drug treatment within the past 30 days, or received more than 10 mg of prednisolone per day (or other hormones at the same dose) continuous treatment;

• History of solid organ or bone marrow transplantation;

• Chronic nephrosis;

• Severe chronic liver disease (child-Pugh: Grade C);

• alcohol or opioid dependence, mental illness, or severe cognitive impairment;

• Pregnant or breastfeeding;

• Patients and/or their family members refuse to participate in the trial.