{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:29:30Z","timestamp":1793726970193,"version":"4.6.1"},"reference-count":68,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Specific sedative hypnotic agents, administered to facilitate endotracheal intubation (ETI) in critically ill adults, may lead to adverse outcomes such as peri-intubation cardiovascular collapse. However, little is known from systematic investigations of the impact these individual agents have on cardiovascular function or other clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>MEDLINE, Embase, CENTRAL, ClinicalTrials.gov, Scopus and Web of science databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study selection<\/jats:title>\n                    <jats:p>We conducted a systematic search for randomized and non-randomized studies that evaluated adult (\u226518 years) critically ill patients who were sedated to facilitate ETI with ketamine, propofol, ketamine\/propofol, etomidate, or a benzodiazepine and who had data on peri-intubation hemodynamics and at least one other outcome involving acute kidney injury, delirium, opioid use, intubation difficulty, sequential organ failure assessment, length of stay, or mortality. Eighty-five studies were identified for eligibility assessment with 23 included in the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction<\/jats:title>\n                    <jats:p>Two reviewers independently screened articles, extracted data from selected articles, and assessed risk of bias using ROBINS-I for observational studies and revised Cochrane Risk of Bias tool for randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data synthesis<\/jats:title>\n                    <jats:p>Acute cardiovascular dysfunction (peri-intubation hemodynamic instability and\/or cardiac arrest) was similar between etomidate and ketamine with more events seen when propofol versus non-propofol sedation was administered. However, exploratory meta-analysis demonstrated no difference between etomidate and ketamine (OR 1.05 [95%CI 0.60-1.84]) or between etomidate and propofol (OR 0.91 [95%CI 0.33-2.46]). Compared to ketamine, etomidate demonstrated lower survival to hospital discharge in the included studies in exploratory meta-analysis OR 0.76 (95%CI 0.62-0.92). Limited data existed for other outcomes with no discernible differences between sedative agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acute cardiovascular dysfunction was more common when propofol, as compared to non-propofol sedation, was administered, although not statistically significant in exploratory meta-analysis. In addition, etomidate conferred lower survival to hospital discharge versus non-etomidate sedation, which was confirmed in exploratory meta-analysis of etomidate versus ketamine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666251337702","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T19:47:59Z","timestamp":1747252079000},"page":"706-723","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of Sedative Hypnotic Agents Used for Endotracheal Intubation in Critically Ill Adults: A Systematic Review with Exploratory Meta-Analysis"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1051-098X","authenticated-orcid":false,"given":"Nathan J.","family":"Smischney","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Division of Critical Care Medicine, Mayo Clinic, Rochester, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Williams","sequence":"additional","affiliation":[{"name":"Texas Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6687-3953","authenticated-orcid":false,"given":"Craig S.","family":"Jabaley","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Critical Care Medicine, Emory University, Atlanta, USA"},{"name":"Emory Critical Care Center, Atlanta, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish K.","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, USA"},{"name":"Outcomes Research Consortium, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Bouldin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Petrilli","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Deng","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elissa A.","family":"Kinzelman-Vesely","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3998-7637","authenticated-orcid":false,"given":"Ronald G.","family":"Pearl","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"issue":"12","key":"e_1_3_5_2_2","doi-asserted-by":"crossref","DOI":"10.2196\/11101","article-title":"Endotracheal intubation among the critically ill: Protocol for a multicenter, observational, prospective study","volume":"7","author":"Smischney N","year":"2018","unstructured":"Smischney N, Kashyap R, Seisa M, Schroeder D, Diedrich D. 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