Effect of Ketamine and Etomidate During RSI on Long Term Outcomes (RSI-LTO)

This observational cohort study (n=1756) aims to collect long-term outcomes from the RSI trial (NCT05277896). It was conducted by Vanderbilt University Medical Center and led by Jonathan Casey, MD, MSc.

The study investigates the potential of ketamine and etomidate in preventing symptoms of post-traumatic stress disorder (PTSD) in critically ill adults undergoing emergency tracheal intubation.

PTSD is a common psychiatric disorder triggered by traumatic events, including medical procedures such as intubation. The study seeks to assess whether ketamine, by blocking pathways in the brain’s glutaminergic system responsible for traumatic memories, can prevent or reduce PTSD symptoms. Previous research has shown that a single dose of ketamine can alleviate PTSD symptoms for up to two weeks in outpatients with chronic PTSD. The study aims to enroll 1,756 participants and is estimated to be completed by March 2028.

This study will include participants in the RSI trial who meet the eligibility criteria for long-term outcomes assessment. Participants must be adults enrolled in the RSI trial and able to follow commands prior to tracheal intubation. Exclusions include aphasic or nonverbal individuals prior to intubation, non-English speakers, and the deaf.

The study design involves two cohorts: one receiving intravenous ketamine and the other receiving intravenous etomidate as sedatives for induction of anesthesia during emergency tracheal intubation. Primary outcome measures include PTSD symptoms at 12 months, assessed using the Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Secondary measures include vital status, awareness of paralysis, ICU memories, threat perception, anxiety, depression, quality of life, global cognition, executive function, loss of employment, and physical disability.

Data-sharing plans include making individual patient data available to researchers with approved protocols and proposals. The study started on April 6, 2022, and is estimated to conclude by January 2027. Recruitment is ongoing in Nashville, Tennessee, United States, with Jonathan D Casey as the primary contact.

Topic PTSD
Compound Ketamine
Country United States of America
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