An observational study in Trauma and Rapid Sequence Intubation, sponsored by University of Southern California. Withdrawn at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-05-04.
Sponsored by University of Southern California · Observational
To compare the outcomes of the use of propofol, etomidate, and ketamine as induction agents for adult trauma patients undergoing intubation within 24 hours of admission. The primary goal is to determine the ideal agent that should be used in this patient population for intubations.
Rationale:
Although rapid sequence intubation (RSI) is commonly used in the emergency department (ED) or operating room (OR) for trauma patients, there is not one induction medication which has been deemed the drug of choice for this particular use. There is a wide variation in induction agents used by providers performing RSIs, including propofol, ketamine, methohexital, midazolam, fentanyl, and etomidate. However, no society guidelines exist on the induction agent of choice in trauma for either hemodynamically stable or unstable patients. The purpose of this study is to compare the effects of 3 of the most commonly used induction agents (propofol, etomidate, and ketamine) for RSIs in adult trauma patients on outcomes, such as mortality, and hemodynamic status. Ultimately, the investigators would like to lay the groundwork for developing guidelines that define the ideal induction agent for trauma RSIs.
Intervention: Giving propofol, ketamine, or etomidate as the induction medication for a rapid sequence intubation in trauma patients requiring intubation within 24 hours of admission.
Objectives/Purpose: The purpose of this study is to compare the effects of 3 of the most commonly used induction agents (propofol, etomidate, and ketamine) for RSIs in adult trauma patients on outcomes such as mortality. Additionally, how each agent effects patients' hemodynamic status will be evaluated. Additional outcomes of these medications will be studied in three subsets of patients: 1. those with traumatic brain injuries, 2. elderly patients (>=65-years-old), and 3. those with a low shock index (\<0.9) compared to a high shock index (>0.9). Finally, the practices and outcomes of RSIs performed in the ED versus the OR will be compared. Ultimately, the investigators would like to lay the groundwork for developing guidelines that define the ideal induction agent for trauma RSIs.
Study population: Adult trauma patients undergoing RSI within 24 hours of hospital admission
Methodology: A multicenter, prospective observational study will be performed.
Endpoints: In-hospital mortality, 28-day mortality, ICU and total hospital length of stay, complications, hypotension and vasopressor use 30 minutes and 24 hours after intubation, mechanical ventilator days, and discharge disposition
Statistic plan: Data will be entered into a password-protected online data collection tool known as RedCap, and analyzed using SAS version 9.4 (SAS Institute, Inc., Cary, NC).
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Adult trauma patients requiring intubation within 24 hours of hospital admission.
Exclusion Criteria:
Patients who received an induction medication for intubation.
Drug: Ketamine · Drug: Etomidate · Drug: Propofol
Administering ketamine as an induction medication for intubating adult trauma patients within 24 hours of hospital admission.
Also known as: Ketalar
Administering etomidate as an induction medication for intubating adult trauma patients within 24 hours of hospital admission.
Also known as: Amidate
Administering propofol as an induction medication for intubating adult trauma patients within 24 hours of hospital admission.
Also known as: Diprivan
in-hospital mortality
mortality
Time frame: through study completion, an average of 1 year
total hospital length of stay
days
Time frame: through study completion, an average of 1 year
intensive care unit length of stay
days
Time frame: through study completion, an average of 1 year
mechanical ventilator days
days
Time frame: through study completion, an average of 1 year
Number of participants with hypotension
defined as systolic blood pressure\<90 mmHg or mean arterial pressure \<50 mmHg
Time frame: 30 minutes after intubation
Number of participants with hypotension
defined as systolic blood pressure\<90 mmHg or mean arterial pressure \<50 mmHg
Time frame: 24 hours after intubation
Number of participants requiring vasopressor use
vasopressor use
Time frame: 30 minutes after intubation
Number of participants requiring vasopressor use
vasopressor use
Time frame: 24 hours post intubation
number of complications
examples: adrenal insufficiency, aspiration, pneumonia, acute respiratory distress syndrome, organ failure, etc.
Time frame: through study completion, an average of 1 year
28-day mortality
28 day mortality
Time frame: 28 days after admission
discharge disposition
examples: discharge home no services, home with services, skilled nursing facility, rehabilitation center, etc.
Time frame: through study completion, an average of 1 year
Plan to share: Undecided
This study is withdrawn, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.
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University of Southern California