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Etomidate should be used carefully for emergent endotracheal intubation in patients with septic shock

Cited 13 time in Web of Science Cited 16 time in Scopus
Authors
Kim, Tae Yun; Rhee, Joong Eui; Kim, Kyu Seok; Cha, Won Chul; Suh, Gil Jun; Jung, Sung Koo
Issue Date
2009-01-03
Publisher
Korean Academy of Medical Sciences
Citation
J Korean Med Sci. 2008 ;23(6):988-91.
Keywords
Adrenal Cortex Hormones/therapeutic useAdrenal Insufficiency/chemically induced/complicationsAgedAnesthetics, Intravenous/*adverse effectsEtomidate/*adverse effectsFemaleHumans*Intubation, IntratrachealMaleMidazolam/*adverse effectsMiddle AgedRetrospective StudiesShock, Septic/complications/drug therapy/*mortality
Abstract
Etomidate and midazolam are the most popular drugs among the induction agents for emergent endotracheal intubation. The purpose of this study was to compare the incidence of adrenal insufficiency and mortality between the septic shock patients who received etomidate (ETM group) and those who received midazolam (MDZ group). Between November 2004 and September 2006, 65 patients were analyzed in this study. The hospital mortality rate was 36% in the ETM group (n=25) and 50% in the MDZ group (n=40), which was not statistically significant (p=0.269). The incidence of relative adrenal insufficiency was significantly higher in the ETM group than in the MDZ group (84% and 48%, respectively; p=0.003). On multivariate analysis, the use of etomidate was the only significant factor affecting the incidence of relative adrenal insufficiency (odds radio, 5.59; 95% confidence interval, 1.61-19.4). In conclusion, we think that physicians who treat patients with septic shock should be aware that etomidate can cause adrenal insufficiency, and should start corticosteroids if etomidate is administered.
ISSN
1011-8934 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19119441

http://hdl.handle.net/10371/63067
DOI
https://doi.org/10.3346/jkms.2008.23.6.988
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College of Medicine/School of Medicine (의과대학/대학원)Emergency Medicine (응급의학전공)Journal Papers (저널논문_응급의학전공)
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