{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:13:07Z","timestamp":1790619187351,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective was to determine whether the use of fentanyl with ketamine for emergency department (ED) rapid sequence intubation (RSI) results in fewer patients with systolic blood pressure (SBP) measurements outside the pre\u2010specified target range of 100\u2013150\u00a0mm\u00a0Hg following the induction of anesthesia.<\/jats:p><jats:p>Methods<\/jats:p><jats:p>This study was conducted in the ED of five Australian hospitals. A total of 290 participants were randomized to receive either fentanyl or 0.9% saline (placebo) in combination with ketamine and rocuronium, according to a weight\u2010based dosing schedule. The primary outcome was the proportion of patients in each group with at least one SBP measurement outside the prespecified range of 100\u2013150\u00a0mm\u00a0Hg (with adjustment for baseline abnormality). Secondary outcomes included first\u2010pass intubation success, hypotension, hypertension and hypoxia, mortality, and ventilator\u2010free days 30\u00a0days following enrollment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 142 in the fentanyl group and 148 in the placebo group commenced the protocol. A total of 66% of patients receiving fentanyl and 65% of patients receiving placebo met the primary outcome (difference\u00a0=\u00a01%, 95% CI\u00a0=\u00a0\u221210 to 12). Hypotension (SBP\u00a0\u2264\u00a099\u00a0mm\u00a0Hg) was more common with fentanyl (29% vs. 16%; difference\u00a0=\u00a013%, 95% CI\u00a0=\u00a03% to 23%), while hypertension (\u2265150\u00a0mm\u00a0Hg) occurred more with placebo (69% vs. 55%; difference\u00a0=\u00a014%, 95% CI\u00a0=\u00a03 to 24). First\u2010pass success rate, 30\u00a0day mortality, and ventilator\u2010free days were similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>There was no difference in the primary outcome between groups, although lower blood pressures were more common with fentanyl. Clinicians should consider baseline hemodynamics and postinduction targets when deciding whether to use fentanyl as a coinduction agent with ketamine.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14446","type":"journal-article","created":{"date-parts":[[2022,1,22]],"date-time":"2022-01-22T18:27:45Z","timestamp":1642876065000},"page":"719-728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Fentanyl versus placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department: The <scp>FAKT<\/scp> study\u2014A randomized clinical trial"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5915-6315","authenticated-orcid":false,"given":"Ian","family":"Ferguson","sequence":"first","affiliation":[{"name":"South West Clinical School University of New South Wales  Sydney New South Wales Australia"},{"name":"Emergency Department Liverpool Hospital 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