Abstract:
:Etomidate is commonly used for the facilitation of endotracheal intubation. While etomidate possesses multiple qualities that are beneficial in hemodynamically unstable patients who require a sedative or amnestic, its potential to negatively impact corticosteroid production is well-documented. Given the frequency of relative adrenal insufficiency observed in the critically ill and the increasing use of corticosteroids in patients with septic shock, an appraisal of the status of etomidate as an induction agent in patients with evolving or established septic shock is indicated. A review of the relevant literature suggests that its use in this setting may be harmful. It is proposed that, pending the performance of a randomized, controlled clinical trial, considerable caution should accompany its administration in patients with evolving or established septic shock. The potential role for concomitant empiric steroid replacement and the comparability of alternative induction regimens are also discussed.
journal_name
Chestjournal_title
Chestauthors
Jackson WL Jrdoi
10.1378/chest.127.3.1031subject
Has Abstractpub_date
2005-03-01 00:00:00pages
1031-8issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(15)31117-Xjournal_volume
127pub_type
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