NCT03420950

Drug Order for Rapid Sequence Intubation

Drug Order for Rapid Sequence Intubation in Emergency Department Intubation

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 335 (actual)
• Sponsor: Hennepin Healthcare Research Institute · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This is a randomized, blinded trial comparing the order of drug administration for rapid sequence intubation in the Emergency Department.

Detailed description

Based on data (excluding outliers) from protocol 16-4146, the intubation time with the paralytic and sedative first administered is 86 s, and 93 s, respectively, with a standard deviation of approximately 25-30 s. Using these assumptions, 470 patients (235 per group) will need to be enrolled to detect an 7 s absolute difference between groups with 80% power. Because a greater difference is anticipated in those who receive rocuronium rather than succinylcholine (because succinylcholine takes action faster), goal enrollment is 470 patients who receive rocuronium as the paralytic who are intubated successfully on the first attempt. The total enrollment will be higher, accounting for those who receive succinylcholine and those who are not successful on the first attempt. The data for those who receive succinylcholine first will be reported and is planned to be used to determine the feasibility of a future trial. The primary group of analysis will be those receiving rocuronium, because this medication acts somewhat slower than succinylcholine. Patients who receive either drug will be analyzed, but it is pre-specified that the group of interest are those receiving rocuronium. The primary outcome, first intubation attempt duration, and apnea duration will be measured only in those with a successful first attempt because these timing events will be confounded by attempt failure; in these cases the altered duration will have more to do with device or patient characteristics than with drug order. The remainder of the outcomes will be measured in all enrolled subjects in an intention to treat analysis. An analysis for patients by RSI drug order actually received, regardless of treatment allocation, will also be presented.

Conditions

• Acute Respiratory Failure

Interventions

Type	Name	Description
OTHER	Rapid sequence intubation: sedative first	Sedative first
OTHER	Rapid sequence intubation: paralytic first	Paralytic first

Timeline

• Start date: 2018-02-05
• Primary completion: 2021-09-29
• Completion: 2021-09-29
• First posted: 2018-02-05
• Last updated: 2022-02-03

Locations

1 site across 1 country: United States