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01-07-2010 | Correspondence

Is etomidate really that bad in septic patients?

Author: Fabio Moreira Andrade

Published in: Intensive Care Medicine | Issue 7/2010

Excerpt

I congratulate Cuthbertson et al. [1] for their effort to enlighten the debate [2‐10] on etomidate safety in critically ill patients. Nevertheless I cannot agree with some conclusions in their paper. I also would like to ask some questions to the authors, which I believe would help readers to understand some statements in their publication. …

Cuthbertson BH, Sprung CL, Annane D, Chevret S, Garfield M, Goodman S, Laterre PF, Vincent JL, Freivogel K, Reinhart K, Singer M, Payen D, Weiss YG (2009) The effects of etomidate on adrenal responsiveness and mortality in patients with septic shock. Intensive Care Med 35:1868–1876CrossRefPubMed

Riché FC, Boutron CM, Valleur P, Berton C, Laisné MJ, Launay JM, Chappuis P, Peynet J, Vicaut E, Payen D, Cholley BP (2007) Adrenal response in patients with septic shock of abdominal origin: relationship to survival. Intensive Care Med 33:1761–1766CrossRefPubMed

Vinclair M, Braux C, Faure P, Brun J, Genty C, Jacquot C, Chabre O, Payen JF (2008) Duration of adrenal inhibition following a single dose of etomidate in critically-ill patients. Intensive Care Med 34:712–719CrossRef

Kim TY, Rhee JE, Kim KS, Cha WC, Suh GJ, Jung SK (2008) Etomidate should be used carefully for emergent endotracheal intubation in patients with septic shock. J Korean Med Sci 23:988–991CrossRefPubMed

Zed PJ, Mabasa VH, Slavik RS, Abu-Laban RB (2006) Etomidate for rapid sequence intubation in the emergency department: is adrenal suppression a concern? CJEM 8:347–350PubMed

Walls RM, Murphy MF (2008) Clinical controversies: etomidate as an induction agent for endotracheal intubation in patients with sepsis: continue to use etomidate for intubation of patients with septic shock. Ann Emerg Med 52:13–14CrossRefPubMed

Sachetti A (2008) Etomidate: not worth the risk in septic patients. Ann Emerg Med 52:14–16CrossRef

Jackson WL Jr (2005) Should we use etomidate as an induction agent for endotracheal intubation in patients with septic shock? A critical appraisal. Chest 127:1031–1038CrossRefPubMed

Tekwani KL, Watts HF, Rzechula KH, Sweis RT, Kulstad EB (2009) A prospective observational study of the effect of etomidate on septic patient mortality and length of stay. Acad Emerg Med 16:11–14CrossRefPubMed

10.

Hildreth AN, Meija VA, Maxwell RA, Smith PW, Dart BW, Barker DE (2008) Adrenal suppression following a single dose of etomidate for rapid sequence induction: a prospective randomized study. J Trauma 65:573–579CrossRefPubMed

11.

Jabre P, Combes X, Lapostolle F, Dhaouadi M, Ricard-Hibon A, Vivien B, Bertrand L, Beltramini A, Gamand P, Albizzati S, Perdrizet D, Lebail G, Chollet-Xemard C, Maxime V, Brun-Buisson C, Lefrant JY, Bollaert PE, Megarbane B, Ricard JD, Anguel N, Vicaut E, Adnet F, KETASED Collaborative Study Group (2009) Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. Lancet 374:293–300CrossRefPubMed

12.

Annane D (2005) ICU physicians should abandon the use of etomidate! Intensive Care Med 31:325–326CrossRefPubMed

Title: Is etomidate really that bad in septic patients?
Author: Fabio Moreira Andrade
Publication date: 01-07-2010
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-010-1878-5

Keynote webinar | Spotlight on medication adherence

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Is etomidate really that bad in septic patients?

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Keynote webinar | Spotlight on medication adherence

Springer Medicine

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