biostudies-literatureUnknown8(12)Maia IWA<h4>Importance</h4>The choice of induction agent during rapid sequence intubation (RSI) of critically ill adults may affect clinical outcomes. Although ketamine and etomidate are frequently used for RSI, their comparative effectiveness remains controversial.<h4>Objective</h4>To compare the safety of etomidate vs ketamine for emergency RSI in critically ill adults.<h4>Design, setting, and participants</h4>This cohort study used a target trial emulation with observational data collected between March 1, 2022, and April 30, 2024, from 18 emergency departments across Brazil, with data from the Brazilian Airway Registry Cooperation. Adults who underwent RSI and received either etomidate or ketamine as a sole hypnotic agent were included; those with preintubation cardiac arrest or immediate postJAMA network opene2548060https://www.ebi.ac.uk/biostudies/studies/S-EPMC12706683biostudies-literatureKetamine, Etomidate, and Mortality in Emergency Department Intubations.PMC12706683Quadros Antoniazzi LBogutchi Sarubi TRSilva Padiha LMartins DMullan AVieira de Lyra IMRodrigues MDDFernando Morgado FLopes Cancado Lira MFurtado Santos APKorssak Goncalves GRosa Fernandes ERFHelena Kilian HKMartins Lopes IDal Pra KSaito Goes ASGLocatelli Da Silva CLDSRodrigues Schramm IMartins Lopes CMoraes JPPereira Barbosa BMartins PNicaretta da Silva IBender Fuhr NMartins WCoester ABertoldi Lemos Teodoro ACAguiar MMDelogo Sinete CMoreira NPOliveira Dos Santos TTahim de Sousa Brasil Othon Sidou LBlini Mariucio JSanches Nunes LBesen BAMPSantos MKlug Cogo ACReis Santiago IRibeiro Dias GEsteves Pelicer MRaimondi Sudbrack TLopes Moreira MCandido 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Oliveira LRosseti PRBittencourt Macedo Rocha MFerreira Ramos ALde Camargo Zimmer Vilhena JVSartor Poloni VDullius Oliveira JAraujo de Carvalho AJACDias de Souza GGarziera GBruna Zagonel BFagundes Bonardi NPMitsue Pereira Suzuki CMPSQueda Toledo GCampos Alonge RClarck Barros JCLima Mc Gregor Von Hellmann RPagnard YPTorres Y Moreno Batista STobias Lazaroto VFlor da Costa ACSilva de Freitas MLPereira da Silva JMde Abreu Tda Silva Rabelo PEmos de Araujo LKniss JResende Scapim JPDe Vasconcellos Fonteles Teixeira LBadwan Mustafa YfalseKetamine, Etomidate, and Mortality in Emergency Department Intubations.<h4>Importance</h4>The choice of induction agent during rapid sequence intubation (RSI) of critically ill adults may affect clinical outcomes. Although ketamine and etomidate are frequently used for RSI, their comparative effectiveness remains controversial.<h4>Objective</h4>To compare the safety of etomidate vs ketamine for emergency RSI in critically ill adults.<h4>Design, setting, and participants</h4>This cohort study used a target trial emulation with observational data collected between March 1, 2022, and April 30, 2024, from 18 emergency departments across Brazil, with data from the Brazilian Airway Registry Cooperation. Adults who underwent RSI and received either etomidate or ketamine as a sole hypnotic agent were included; those with preintubation cardiac arrest or immediate post2025-01-01T00:00:00Z2025 Dec2026-07-15T06:33:51.856Z2026-06-30T03:19:55.079ZS-EPMC127066834139660410.1001/jamanetworkopen.2025.48060