Incidence of post-induction hypotension following emergency rapid sequence induction with ketamine: a systematic review and meta-analysis.
Scandinavian journal of trauma, resuscitation and emergency medicine May 1, 2025 Pedro Vila de Mucha, Stephen Thomas 5 citations
Ketamine does not reduce the incidence of post-induction hypotension (PIH) compared to other agents when used for emergency rapid sequence induction (RSI). A systematic review and meta-analysis of 27 studies (31,956 patients) found a pooled odds ratio of 1.10 (95% CI 0.78–1.56) for PIH with ketamine versus alternative induction agents. After excluding studies at higher risk of bias, the odds ratio was 0.99 (0.69–1.43). No significant difference emerged in any subgroup, though a comparison with etomidate approached significance (OR 1.38, p = 0.058). The optimal induction agent likely depends on specific clinical circumstances not yet fully understood.