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.
Who can participate
Age range
18 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Patients aged ≥ 18 years old without restriction of gender, race, religion, creed or nationality;
* No use of sedatives within the half-life of their elimination before inclusion；
* Patients and/or their family members know and agree to participate in the trial.
Exclusion Criteria:
* Age \<18 years,Allergy to esketamine or midazolam;
* Endotracheal tract required intubation without notsedative drugs, such as cardiac arrest、neurologic dysfunction or the need for awake intubation
* Patients with suspected elevated intracranial pressure;
* Bradycardia (heartrate (HR) less than 50 beats / min) or atrioventricular block；
* Untreated or undertreated hyperthyroid patients;
* Chronic kidney disease;
* Severe chronic liver disease (child-Pugh: Grade C);
* Alcohol or opioid dependence, mental illness, or severe cognitive impairment;
* Pregnancy or lactation;
* Lack of informed consent.
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Mean Arterial Pressure Before, During, and After Tracheal Intubation
Timeframe: From 5 minutes before induction through 60 minutes after tracheal intubation.
2
Heart Rate Before, During, and After Tracheal Intubation
Timeframe: From 5 minutes before induction through 60 minutes after tracheal intubation.
3
Peripheral Oxygen Saturation Before, During, and After Tracheal Intubation
Timeframe: From 5 minutes before induction through 60 minutes after tracheal intubation.
Trial details
NCT IDNCT05464979
SponsorUnion Hospital, Tongji Medical College, Huazhong University of Science and Technology