Comparative Efficacy and Safety of Propofol-Ketamine Combination Versus Propofol Monotherapy in Geriatric Patients Under Invasive Ventilation
The study is a prospective randomized controlled trial comparing the efficacy and safety of propofol-ketamine (Ketofol) versus propofol monotherapy in geriatric ICU patients. Eligible participants are critically ill elderly patients with a history of cardiac disease who require endotracheal intubation and have not yet received sedation. The investigators focus on a specific population in which geriatric patients have different pharmacokinetics and pharmacodynamics and are more prone to side effects than other populations. Primary outcome: Incidence of hemodynamic instability (defined as hypotension requiring vasopressors), measured by mean arterial pressure (MAP) at baseline, during intubation, and post-intubation at 1, 3, 5, 10, 20, 30, and 60 minutes, then hourly for 24 hours.
• Age ≥ 65 years
• Admitted to ICU with a diagnosis of infection (sepsis, septic shock, or pneumonia)
• Known history of cardiac disease (e.g., ischemic heart disease, heart failure, arrhythmias)
• Requiring endotracheal intubation for airway protection or respiratory failure
• Informed consent obtained from patient or legal representative
• Patient NOT on sedation prior randomization.