LAUSR

We greatly appreciate the interest [1] in the dose of ketamine appropriate for anesthetic induction in critically ill patients. There is substantial variability in what could be considered appropriate dosing of ketamine in this setting [2]. In the EvK Clinical Trial, our Airway Team used a suggested dose of ketamine 1–2 mg/kg intravenous, but allowed for clinician-directed individualized dosing based on contemporaneous usual-care standards as interpreted by the clinicians at the bedside [3]. In Electronic Supplementary Material-3 (ESM-3), we provide some additional exploratory data from the trial related to dosing of medications. As is evident in ESM3, our clinicians engaged in extensive individualization of dosing of etomidate, ketamine, rocuronium and succinylcholine (ESM-3, Figs. 1–13). Scatter plots of the dose of etomidate or ketamine and various outcomes were largely unrevealing (ESM-3, Figs. 14–19). The data in ESM-3 are highly exploratory and should be seen as hypothesis generating. There are many unanswered questions about etomidate and ketamine in critically ill patients. Neither the main findings of the EvK Clinical Trial, nor ESM-3, provide answers that should be presumed to be definitive or widely generalizable. We hope Barthélémy and others will pursue further studies in this domain, and we hope our data might aid in designing or operationalizing those studies. Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s0013402206671-8.