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Etomidate for rapid sequence intubation in the emergency department: Is adrenal suppression a concern?

Published online by Cambridge University Press:  21 May 2015

Peter J. Zed ,
Vincent H. Mabasa ,
Richard S. Slavik  and
Riyad B. Abu-Laban
Peter J. Zed*
Affiliation:
Emergency Medicine, CSU Pharmaceutical Sciences, Vancouver General Hospital, Faculty of Pharmaceutical Sciences, Division of Emergency Medicine, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC
Vincent H. Mabasa
Affiliation:
Critical Care, Department of Pharmacy, Royal Columbian Hospital, New Westminster, BC
Richard S. Slavik
Affiliation:
Critical Care, CSU Pharmaceutical Sciences, Vancouver General Hospital; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC
Riyad B. Abu-Laban
Affiliation:
Department of Emergency Medicine, Vancouver General Hospital; Vancouver Coastal Health Research Institute Centre for Clinical Epidemiology & Evaluation; Michael Smith Foundation for Health Research; University of British Columbia, Vancouver, BC
*
CSU Pharmaceutical Sciences, Vancouver General Hospital, 855 West 12th Ave., Vancouver BC V5Z 1M9

Abstract

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Keywords

etomidateintubationadrenal insufficiency

Information

Type
Commentary • Commentaire
Information
Canadian Journal of Emergency Medicine , Volume 8 , Issue 5 , September 2006 , pp. 347 - 350
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

References

1.Zed, PJ, Abu-Laban, RB, Harrison, DW. Intubating conditions and hemodynamic effects of etomidate for rapid sequence intubation in the emergency department: an observational cohort study. Acad Emerg Med 2006;13:378–83.CrossRefGoogle ScholarPubMed
2.Zuckerbraun, NS, Pitetti, RD, Herr, SM, et al. Use of etomidate as an induction agent for rapid sequence intubation in a pediatric emergency department. Acad Emerg Med 2006;13:602–9.CrossRefGoogle Scholar
3.Sakles, JC, Laurin, EG, Rantapaa, AA, et al. Airway management in the emergency department: a one-year study of 610 tracheal intubations. Ann Emerg Med 1998;31:325–32.CrossRefGoogle ScholarPubMed
4.Murray, H, Marik, PE. Etomidate for endotracheal intubation in sepsis. Acknowledging the good while accepting the bad. Chest 2005;127:707–9.CrossRefGoogle ScholarPubMed
5.Jackson, WL. Should we use etomidate as an induction agent for endotracheal intubation in patients with septic shock? A critical appraisal. Chest 2005;127:1031–8.CrossRefGoogle ScholarPubMed
6.Morris, C, McAllister, C. Etomidate for emergency anaesthesia: mad, bad and dangerous to know? [editorial]. Anaesthesia 2005;60:737–40.CrossRefGoogle ScholarPubMed
7.Annane, D. ICU physicians should abandon the use of etomidate! Intensive Care Med 2005;31:325–6.Google Scholar
8.Smith, CE. Rapid-sequence intubation in adults: indications and concerns. Clin Pulm Med 2001;8:147–65.CrossRefGoogle Scholar
9.Walls, RM. Rapid sequence intubation. In: Walls, RM, editor. Manual of emergency airway management. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 8–15.Google Scholar
10.Schneider, RE. Sedatives and induction agents. In: Walls, RM, editor. Manual of emergency airway management. Philadelphia: Lippincott Williams & Wilkins; 2000. p.129–34.Google Scholar
11.Yeung, JK, Zed, PJ. A review of etomidate for rapid sequence intubation in the emergency department. Can J Emerg Med 2002;4(3):194–8.CrossRefGoogle ScholarPubMed
12.Bergen, JM, Smith, DC. A review of etomidate for rapid sequence intubation in the emergency department. J Emerg Med 1997;15:221–30.CrossRefGoogle ScholarPubMed
13.Doenicke, A. Etomidate, a new intravenous hypnotic. Acta Anesthesiol Belg 1974;3:307–15.Google Scholar
14.Willman, E, Litchfield, A, Andolfatto, G. Etomidate and rapid sequence intubation [letter]. Can J Emerg Med 2005;7(1):4.CrossRefGoogle ScholarPubMed
15.Ledingham, IM, Watt, I. Influence of sedation on mortality in critically ill multiple trauma patients [letter]. Lancet 1983;1:1270.Google Scholar
16.Watt, I, Ledingham, IM. Mortality amongst multiple trauma patients admitted to an intensive therapy unit. Anaesthesia 1984;39:973–81.CrossRefGoogle Scholar
17.Duthie, DJR, Fraser, R, Nimmo, RS. Effect of induction of anesthesia with etomidate on corticosteroid synthesis in man. Br J Anaesth 1985;57:156–9.CrossRefGoogle ScholarPubMed
18.De Coster, R, Helmers, JH, Noorduin, H. Effect on etomidate of cortisol biosynthesis: site of action after induction of anaesthesia. Acta Endocrinol (Copenh) 1985;110:526–31.Google ScholarPubMed
19.Wagner, RL, White, PF, Kan, PB, et al. Inhibition of adrenal steroidogenesis by the anesthetic etomidate. N Engl J Med 1984;310:1415–21.CrossRefGoogle ScholarPubMed
20.Allolio, B, Dorr, H, Stuttmann, R, et al. Effect of a single bolus of etomidate upon eight major corticosteroid hormone and plasma ACTH. Clin Endocrinol (Oxf) 1985;22(3):281–6.CrossRefGoogle ScholarPubMed
21.Crozier, TA, Beck, D, Schlaeger, M, et al. Endocrinological changes following etomidate, midazolam, or methohexital for minor surgery. Anesthesiology 1987;66:628–35.CrossRefGoogle ScholarPubMed
22.Schenarts, CL, Burton, JH, Riker, RR. Adrenocortical dysfunction following etomidate induction in emergency department patients. Acad Emerg Med 2001;8:17.CrossRefGoogle ScholarPubMed
23.Malerba, G, Romano-Girard, F, Cravoisy, A, et al. Risk factors of relative adrenocortical deficiency in intensive care patients needing mechanical ventilation. Intensive Care Med 2005;31:388–92.CrossRefGoogle ScholarPubMed
24.Sagarin, MJ, Barton, ED, Walls, RM, et al. Underdosing midazolam in emergency endotracheal intubation. Acad Emerg Med 2003;10:329–38.CrossRefGoogle ScholarPubMed
25.Diago, MC, Amado, JA, Otero, M, et al. Anti-adrenal action of subanaesthetic dose of etomidate. Anaesthesia 1988;43:644–5.CrossRefGoogle ScholarPubMed
26.Annane, D, Sebille, V, Charpentier, C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002;288:862–71.CrossRefGoogle ScholarPubMed
27.Keh, D, Sprung, C. Use of corticosteroid therapy in patients with sepsis and septic shock: an evidence-based review. Crit Care Med 2004;32(suppl):S527-33.CrossRefGoogle ScholarPubMed
28.Minneci, PC, Deans, KJ, Banks, SM, et al. Meta-analysis: the effects of steroids on survival and shock during sepsis depends on the dose. Ann Intern Med 2004;141:47–56.CrossRefGoogle ScholarPubMed
29.Annane, D, Bellissant, E, Bollaert, PE, et al. Corticosteroids for severe sepsis and shock: a systematic review and meta-analysis. BMJ 2004;329:480–8.CrossRefGoogle Scholar
30.Annane, D, Briegel, J, Keh, D, et al; Corticus Study Coordinators. Clinical equipoise remains for issues of adrenocorticotropic hormone administration, cortisol testing, and therapeutic use of hydrocortisone. Crit Care Med 2003;31:2250–1.CrossRefGoogle ScholarPubMed