Adrenocortical function in critically ill patients 24 h after a single dose of etomidate.


We compared the effects of single doses of etomidate and thiopentone on adrenocortical function in a randomised controlled clinical trial involving 35 critically ill patients who needed a general anaesthetic. Just before induction of anaesthesia, a baseline blood cortisol sample was taken. Twenty-four hours later we performed a short adrenocorticotrophic hormone stimulation test. No patient had a low cortisol level (< 160 nmol.l-1) at any time during the study. Baseline, pre-ACTH and post-ACTH cortisol levels were similar in the two groups. However, significantly more patients in the etomidate group had an ACTH-stimulated cortisol increment < 200 nmol.l-1. The clinical significance of these findings is not clear, but we conclude that single doses of etomidate may interfere with cortisol synthesis for at least 24 h in the critically ill.

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@article{Absalom1999AdrenocorticalFI, title={Adrenocortical function in critically ill patients 24 h after a single dose of etomidate.}, author={Anthony R. Absalom and David Pledger and Alex C Kong}, journal={Anaesthesia}, year={1999}, volume={54 9}, pages={861-7} }