Etomidate is associated with mortality and adrenal insufficiency in sepsis: A meta-analysis*

@article{Chan2012EtomidateIA,
  title={Etomidate is associated with mortality and adrenal insufficiency in sepsis: A meta-analysis*},
  author={Chee Man Chan and Anthony L. Mitchell and Andrew F. Shorr},
  journal={Critical Care Medicine},
  year={2012},
  volume={40},
  pages={2945–2953}
}
Objective:To evaluate the effects of single-dose etomidate on the adrenal axis and mortality in patients with severe sepsis and septic shock. Design:A systematic review of randomized controlled trials and observational studies with meta-analysis. Setting:Literature search of EMBASE, Medline, Cochrane Database, and Evidence-Based Medical Reviews. Subjects:Sepsis patients who received etomidate for rapid sequence intubation. Interventions:None. Measurements and Main Results:We conducted a… 
Etomidate, Adrenal Insufficiency and Mortality Associated With Severity of Illness: A Meta-Analysis
TLDR
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The effect of etomidate on mortality in sepsis remains unclear.
TLDR
The authors concluded that etomidate usage for rapid sequence intubation (RSI) is associated with higher rates of mortality in sepsis, and contend that the results presented in their article are misleading.
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TLDR
Current evidence indicates that single-dose etomidate does not increase mortality in patients with sepsis, but this finding largely relies on data from observational studies and is potentially subject to selection bias; hence, high-quality and adequately powered RCTs are warranted.
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TLDR
This study found no evidence for differences in key clinical outcome parameters based on anesthesia induction with or without administration of a single dose of etomidate, suggesting that Etomidate might remain an acceptable option for single-dose anesthesia induction.
Anesthetic Induction With Etomidate in Cardiac Surgical Patients: A PRISMA-Compliant Systematic Review and Meta-Analysis.
TLDR
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Association between Etomidate Use for Rapid Sequence Intubation and Adrenal Insufficiency in Sepsis
TLDR
A trend was shown, although not statistically significant, towards the development of AI in septic patients, and in the subset of patients who received etomidate for RSI, there was a non-significant trend toward increased incidence of AI.
The impact of etomidate on mortality in trauma patients
TLDR
The association between use of a single dose of etomidate for emergency tracheal intubation in the trauma patient and mortality is inconclusive and Etomidate administration should be used with caution in trauma patients requiring tracheals.
Effects of etomidate use in ICU patients on ventilator therapy: a study of 12,526 patients in an open database from a single center
TLDR
Etomidate is a poor choice as a hypnotic drug on the first day of mechanical ventilation, as it is associated with a dose-dependent increase in all-cause mortality, and does not improve survival for the first 48 h.
The use of etomidate for rapid sequence induction in septic patients.
TLDR
The recent meta-analysis by Gu et al. provides an accurate and complete assessment of the existing literature on this topic and concludes that etomidate is still utilized for the purposes of RSI in this critically ill patient population and the current data supports this position.
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There is an increased rate of AI and mortality in critically ill patients who received etomidate and non-etomidate anesthesia, and this results in an increased risk ratio (RR) for AI.
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
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