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Open Access 01-08-2006 | Research

The incidence of relative adrenal insufficiency in patients with septic shock after the administration of etomidate

Authors: Zulfiqar Mohammad, Bekele Afessa, Javier D Finkielman

Published in: Critical Care | Issue 4/2006

Abstract

Introduction

Etomidate blocks adrenocortical synthesis when it is administered intravenously as a continuous infusion or a single bolus. The influence of etomidate administration on the incidence of relative adrenal insufficiency in patients with septic shock has not been formally investigated. The objective of this study was to determine the incidence of relative adrenal insufficiency in patients with septic shock after etomidate administration compared with patients with septic shock who did not receive etomidate.

Methods

In this retrospective study, 152 adults with septic shock who had a consyntropin stimulation test between March 2002 and August 2003 in a tertiary medical center were included. Relative adrenal insufficiency was defined as a rise in serum cortisol ≤ 9 μg/dl after the administration of 250 μg of consyntropin. Patients were divided into those who did and those who did not receive etomidate before the stimulation test. The proportion of patients with relative adrenal insufficiency in these two groups was compared using Fischer's exact test. A P of value < 0.05 was considered statistically significant.

Results

The mean age of the patients was 64 years, 59% of patients were male, 97% of patients were white and their hospital mortality rate was 57%. Thirty-eight patients (25%) received etomidate before the cosyntropin stimulation test, and the median (interquartile range) time interval between the administration of the drug and the test was 7 (4–10) hours. The incidence of relative adrenal insufficiency was 76% in the patients who received etomidate compared with 51% in the patients who did not (P = 0.0077).

Conclusion

The incidence of relative adrenal insufficiency in patients with septic shock is increased when the stimulation test is performed after the administration of etomidate.

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Title: The incidence of relative adrenal insufficiency in patients with septic shock after the administration of etomidate
Authors: Zulfiqar Mohammad
Bekele Afessa
Javier D Finkielman
Publication date: 01-08-2006
Publisher: BioMed Central
Published in: Critical Care / Issue 4/2006
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc4979

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The incidence of relative adrenal insufficiency in patients with septic shock after the administration of etomidate

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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