The Effect of Single-Bolus Etomidate on Septic Patient Mortality: A Retrospective Review
Background: Because of its many desirable properties, etomidate is widely used as an induction agent for endotracheal intubation. However, some have recently called into question the safety of etomidate for even single-bolus use due to its known effects on adrenal suppression.Objectives: We sought t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2008-11-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/7793b6rm |
| _version_ | 1828826669271482368 |
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| author | Rzechula, Kathleen H Nanini, Steve Chan, MD, Cindy W Watts, Hannah F Tekwani, Karis L Kulstad, Erik B |
| author_facet | Rzechula, Kathleen H Nanini, Steve Chan, MD, Cindy W Watts, Hannah F Tekwani, Karis L Kulstad, Erik B |
| author_sort | Rzechula, Kathleen H |
| collection | DOAJ |
| description | Background: Because of its many desirable properties, etomidate is widely used as an induction agent for endotracheal intubation. However, some have recently called into question the safety of etomidate for even single-bolus use due to its known effects on adrenal suppression.Objectives: We sought to compare the in-hospital mortality between septic patients given etomidate and those given alternative induction agents for intubation.Methods: We performed a retrospective chart review of intubated septic patients treated in our hospital. We collected data from patients over the age of 18 with sepsis who were intubated in the pre-hospital setting, in our emergency department, or on the wards of our hospital, and calculated the in-hospital mortality of each group.Results: We identified 181 patients with sepsis who were intubated over the study period; 135 received etomidate and 46 received alternative agents or no induction agent. Baseline characteristics, vital signs, and laboratory values were similar between the two groups. Of the 46 patients receiving alternative agents or no agent, 18 died, yielding an unadjusted mortality of 39.1% (95% CI 25.5% to 54.6%), while of the 135 patients receiving etomidate, 63 died, for an unadjusted mortality of 46.7% (95% CI 38.1% to 55.4%), P=0.38.Conclusion: We found a non-statistically significant 7.6% absolute increase in mortality in patients given etomidate in our small-sized study population.[WestJEM. 2008;9:195-200.] |
| first_indexed | 2024-12-12T14:43:46Z |
| format | Article |
| id | doaj.art-e484e36079fa4493874e6230b4d248cb |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-12T14:43:46Z |
| publishDate | 2008-11-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-e484e36079fa4493874e6230b4d248cb2022-12-22T00:21:09ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182008-11-0194195200The Effect of Single-Bolus Etomidate on Septic Patient Mortality: A Retrospective ReviewRzechula, Kathleen HNanini, SteveChan, MD, Cindy WWatts, Hannah FTekwani, Karis LKulstad, Erik BBackground: Because of its many desirable properties, etomidate is widely used as an induction agent for endotracheal intubation. However, some have recently called into question the safety of etomidate for even single-bolus use due to its known effects on adrenal suppression.Objectives: We sought to compare the in-hospital mortality between septic patients given etomidate and those given alternative induction agents for intubation.Methods: We performed a retrospective chart review of intubated septic patients treated in our hospital. We collected data from patients over the age of 18 with sepsis who were intubated in the pre-hospital setting, in our emergency department, or on the wards of our hospital, and calculated the in-hospital mortality of each group.Results: We identified 181 patients with sepsis who were intubated over the study period; 135 received etomidate and 46 received alternative agents or no induction agent. Baseline characteristics, vital signs, and laboratory values were similar between the two groups. Of the 46 patients receiving alternative agents or no agent, 18 died, yielding an unadjusted mortality of 39.1% (95% CI 25.5% to 54.6%), while of the 135 patients receiving etomidate, 63 died, for an unadjusted mortality of 46.7% (95% CI 38.1% to 55.4%), P=0.38.Conclusion: We found a non-statistically significant 7.6% absolute increase in mortality in patients given etomidate in our small-sized study population.[WestJEM. 2008;9:195-200.]http://escholarship.org/uc/item/7793b6rmSeptic shockintubationinfectionetomidatemortality |
| spellingShingle | Rzechula, Kathleen H Nanini, Steve Chan, MD, Cindy W Watts, Hannah F Tekwani, Karis L Kulstad, Erik B The Effect of Single-Bolus Etomidate on Septic Patient Mortality: A Retrospective Review Western Journal of Emergency Medicine Septic shock intubation infection etomidate mortality |
| title | The Effect of Single-Bolus Etomidate on Septic Patient Mortality: A Retrospective Review |
| title_full | The Effect of Single-Bolus Etomidate on Septic Patient Mortality: A Retrospective Review |
| title_fullStr | The Effect of Single-Bolus Etomidate on Septic Patient Mortality: A Retrospective Review |
| title_full_unstemmed | The Effect of Single-Bolus Etomidate on Septic Patient Mortality: A Retrospective Review |
| title_short | The Effect of Single-Bolus Etomidate on Septic Patient Mortality: A Retrospective Review |
| title_sort | effect of single bolus etomidate on septic patient mortality a retrospective review |
| topic | Septic shock intubation infection etomidate mortality |
| url | http://escholarship.org/uc/item/7793b6rm |
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