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We would like to congratulate Matchett et al. on their publication of the EvK trial “Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial” [1]. We are particularly interested in the comparative effectiveness observed between etomidate and ketamine in patients with sepsis. Prior data questioning the safety of etomidate for rapid sequence induction was initially published from a population of patients with sepsis [2]. Further, in the KETASED trial in 2019, the point estimate of the effect (although not statistically significant), was the most extreme for the group of patients with sepsis [3]. In the EvK trial, we were interested to see that 34% of the total participants were diagnosed with sepsis prior to randomization, and we think this is a very important cohort in which to estimate the safety of induction medications. We would be very interested, if available, to see an analysis of the sepsis subgroup in the data from the EvK trial.
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Mohr, N.M., Faine, B. Etomidate for endotracheal intubation in sepsis. Intensive Care Med 49, 369 (2023). https://doi.org/10.1007/s00134-022-06962-0
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DOI: https://doi.org/10.1007/s00134-022-06962-0