Healthcare

Using anesthetic particularly etominade (Amidate) to facilitate intubation for patients with severe sepsis or septic shock may not affect the outcome become worst or even death.

This suggestion based on the result of recent observation study among 224 consecutive patients with severe sepsis or septic shock who were intubated and mechanically ventilated in a multidiscplinary intensive care unit at St. Johns Mercy’s Medical Center in St. Louis, by Dr. Dayton Dmello from the division of pulmonary, critical care and sleep medicine of Saint Louis University Hospital in Missouri, and colleagues.

113 of 224 patients received a single dose of etomidate, and 111 patients use no etomidate during perform intubation.

Overall, according to the findings that reported as December issue of Chest, the relative risk of mortality with etomidate was 0.92 (P = 0.51), and it did not increase vasopressor use.
Also, with no difference in outcomes, increased risk of steroid use seen in the etomidate group.

The authors noted that etomidate is “particularly attractive” option during rapid sequence intubation in cases of severe sepsis or septic shock for a variety of reasons, including the relative lack of adverse drug-induced hemodynamic consequences.

However, given that etomidate supresses steroidogenesis and adrenal function, concerns have been raised regarding its safety in critically ill patients.

The authors conclude that “continued use of single-dose etomidate in critically ill patients during rapid sequence intubation appear reasonable, but necessitates a thorough understanding of its potential adverse pharmacodynamic effects on adrenal function.”

Therefore, the authors note that their data should be interpreted cautiously.