The safety of etomidate for emergency rapid sequence intubation of pediatric patients

@article{Sokolove2000TheSO,
  title={The safety of etomidate for emergency rapid sequence intubation of pediatric patients},
  author={Peter Erik Sokolove and Daniel D. Price},
  journal={Pediatric Emergency Care},
  year={2000},
  volume={16},
  pages={18-21}
}
Objective To determine whether pediatric patients given etomidate for rapid sequence intubation (RSI) in the ED develop clinically important hypotension or adrenal insufficiency. Methods Retrospective review of 100 consecutive patients younger than age 10 years given etomidate for RSI in the ED at two academic medical centers. Data were abstracted from ED and in-patient medical records. Clinically important hypotension was defined as a decrease in systolic blood pressure (BP) measurement to… 
Etomidate for rapid-sequence intubation in young children: hemodynamic effects and adverse events.
TLDR
In children less than 10 years old, etomidate seems to produce minimal hemodynamic changes, and appears to have a low risk of clinically important adrenal insufficiency, myoclonus, and status epilepticus.
Etomidate for rapid-sequence intubation in young children: hemodynamic effects and adverse events.
TLDR
In children less than 10 years old, etomidate seems to produce minimal hemodynamic changes, and appears to have a low risk of clinically important adrenal insufficiency, myoclonus, and status epilepticus.
Use of etomidate as an induction agent for rapid sequence intubation in a pediatric emergency department.
TLDR
In the pediatric ED setting, etomidate as an induction agent provided successful RSI conditions and resulted in varied hemodynamic changes that were especially favorable in those patients presenting in decompensated shock.
COMPARISON OF ETOMIDATE AND MIDAZOLAM FOR PREHOSPITAL RAPID-SEQUENCE INTUBATION
TLDR
Intubation success rate was very high with both etomidate and midazolam and there was no statistically significant mean percentage of change in SBP or HR with either agent.
Comparison of etomidate and midazolam for prehospital rapid-sequence intubation.
  • E. Swanson, D. Fosnocht, S. Jensen
  • Medicine
    Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
  • 2004
Etomidate for Short Pediatric Procedures in the Emergency Department
TLDR
For short-duration painful emergency department procedures, etomidate 0.2 mg/kg intravenously administered after fentanyl was associated with effective sedation, successful procedural completion, and readily managed respiratory adverse events in children.
Hemodynamic Responses to Etomidate on Induction of Anesthesia in Pediatric Patients
TLDR
For the entire group, no significant changes in right atrial, aortic, or pulmonary artery pressure, oxygen saturations, calculated Qp:Qs ratio or systemic or pulmonary vascular resistance were detected after the bolus dose of etomidate.
Intubating conditions and hemodynamic effects of etomidate for rapid sequence intubation in the emergency department: an observational cohort study.
TLDR
Etomidate appears to provide appropriate intubating conditions in a heterogeneous group of patients undergoing RSI in the emergency department and Hemodynamic stability appears to be present following administration of this agent, even in patients with low pre-RSI blood pressure.
Avoiding etomidate for emergency intubation : throwing the baby out with the bathwater?
TLDR
Etomidate should preferably be avoided as an RSI drug in the septic patient, and cautiously considered in the trauma patient, provided that steroid supplementation is provided in the event that vasopressor-resistant shock occurs.
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