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This has come up in two threads recently. I haven't looked at all these papers yet(the section below is clipped from Blade MD). All the ones I looked at were in septic patients, but its concerning. To be fair, a "routine" patient and a septic patient are not the same, but its got to make you think.
Blade says:
Here are many peer reviewed articles on Etomidate and Critically ill patients.
Critical Care 2006;10 (4) R105
Critical Care 2007 April 35 (4) 1012-8
Critical Care 2007 May 24; 11 (3); R61
Another good study:
Chest 2005 March; 127 (3) 707-09
It seems if you use Etomidate (even a single low dose) MANY authors are recommending coverage with steroids.
Chest 2006; 10 (4): R105
This study recommends a moratorium on etomidate use period.
The two CHEST journal articles state that etomidate without steroid supplementation will cause 1in 5 patients that got the drug to DIE as a result. Pretty strong wording and a 20% mortality due to etomidate use!
The bottom line is pretty clear: Use etomidate at your own peril and if you use it at all YOU MUST GIVE STEROIDS for several days or more.
What do you guys think? Do you (like me) use etomidate on a regular basis? Are we killing people?
Blade says:
Here are many peer reviewed articles on Etomidate and Critically ill patients.
Critical Care 2006;10 (4) R105
Critical Care 2007 April 35 (4) 1012-8
Critical Care 2007 May 24; 11 (3); R61
Another good study:
Chest 2005 March; 127 (3) 707-09
It seems if you use Etomidate (even a single low dose) MANY authors are recommending coverage with steroids.
Chest 2006; 10 (4): R105
This study recommends a moratorium on etomidate use period.
The two CHEST journal articles state that etomidate without steroid supplementation will cause 1in 5 patients that got the drug to DIE as a result. Pretty strong wording and a 20% mortality due to etomidate use!
The bottom line is pretty clear: Use etomidate at your own peril and if you use it at all YOU MUST GIVE STEROIDS for several days or more.
What do you guys think? Do you (like me) use etomidate on a regular basis? Are we killing people?