A novel use of etomidate for intentional adrenal suppression to control severe hypercortisolemia in childhood

Pediatric Critical Care Medicine

Volumn 10, Issue 3, 2009, Pages

  Mettauer, Nicole ^a   Brierley, Joe ^a  

^a GREAT ORMOND STREET HOSPITAL   (United Kingdom)

Author keywords

Adrenal suppression; Adrenalectomies; Cushing's disease; Cushing's syndrome; Etomidate; Hypercortisolemia

Indexed keywords

ETOMIDATE; HYDROCORTISONE; KETOCONAZOLE; METYRAPONE; INTRAVENOUS ANESTHETIC AGENT;

ADRENAL SUPPRESSION; ADRENALECTOMY; ANAMNESIS; ARTICLE; CASE REPORT; CHILD; CLINICAL FEATURE; COMPUTER ASSISTED TOMOGRAPHY; CONTINUOUS INFUSION; CUSHING DISEASE; HUMAN; HYPERCORTISOLISM; LAPAROSCOPIC SURGERY; LIVER FUNCTION; MALE; NAUSEA AND VOMITING; NUCLEAR MAGNETIC RESONANCE IMAGING; PRESCHOOL CHILD; PRIORITY JOURNAL; SIDE EFFECT; CUSHING SYNDROME; INTENSIVE CARE UNIT;

ADRENALECTOMY; ANESTHETICS, INTRAVENOUS; CHILD; CUSHING SYNDROME; ETOMIDATE; HUMANS; INTENSIVE CARE UNITS, PEDIATRIC; MALE; PITUITARY ACTH HYPERSECRETION;

EID: 68849101237     PISSN: 15297535     EISSN: None     Source Type: Journal    
DOI: 10.1097/PCC.0b013e318198b096     Document Type: Article

References (33)

1. Storr HL, Chan LF, Grossman AB, et al: Paediatric Cushing's syndrome: Epidemiology, investigations and therapeutic advances. Trends Endocrinol Metab 2007; 18: 167-174
2. Nieman LK, Ilias I: Evaluation and treatment of Cushing's syndrome. Am J Med 2005; 118: 1340-1346
3. Kirk LF Jr, Hash RB, Katner HP, et al: Cush-ing's disease: Clinical manifestations and diagnostic evaluation. Am Fam Physician 2000; 62:1119-1127
4. Nieman LK: Medical therapy of Cushing's disease. Pituitary 2002; 5:77-82
5. Sonino N, Boscaro M, Agostino P, et al: Ketoconazole treatment in Cushing's syndrome: Experience in 34 patients. Clin Endocrinol 1991; 35:347-352
6. Verhelst JA, Trainer PJ, Howlett TA, et al: Short and long-term responses to metyrap-one in medical management of 91 patients with Cushing's Syndrome. Clin Endocrinol 1991; 35:169-178
7. Howlett TA, Rees LH, Besser GM: Cushing's syndrome. Clin Endocrinol Metab 1985; 14: 911-945
8. Drake WM, Perry LA, Hinds CJ, et al: Emergency and prolonged use of intravenous eto-midate to control hypercortisolemia in a patient with Cushing's syndrome and peritonitis. J Clin Endocrinol Metab 1998; 83:3542-3544
9. Greening JE, Brain CE, Perry LA, et al: Effi-cient short-term control of hypercortisolaemia by low dose etomidate in severe paediatric Cushing's disease. Horm Res 2005; 64: 140-143
10. Allolio B, Schulte HM, Kaulen D, et al: Non-hypnotic low-dose etomidate for rapid cor- rection of hypercortisolaemia in Cushing's syndrome. Klin Wochenschr 1988; 66: 361-364
11. Schulte HM, Benker G, Reinwein D, et al: Infusion of low dose etomidate: Correction of hypercortisolaemia in patients with Cush-ing's syndrome and dose-related relationship in normal subjects. J Clin Endocrinol Metab 1990; 70:1426-1430
12. Magiakou MA, Smyrnaki P, Chrousos GP: Hypertension in Cushing's syndrome. Best Pract Res Clin Endocrinol Metab 2006; 20: 467-482
13. Porterfield JR, Thompson GB, Young WF Jr, et al: Surgery for Cushing's syndrome: An historical review and recent ten-year experience. World J Surg 2008; 32:659-677
14. Lindholm J, Juul S, Jorgensen JO, et al: Incidence and late prognosis of Cushing's syndrome: A population-based study. J Clin En-docrinol Metab 2001; 86:117-123
15. Whitworth JA, Williamson PM, Mangos G, et al: Cardiovascular consequences of cortisol excess. Vasc Health Risk Manag 2005; 1:291-299
16. Pivonello R, Faggiano A, Lombardi G, et al: The metabolic syndrome and cardiovascular risk in Cushing's syndrome. Endocrinol Metab Clin North Am 2005; 34:327-339
17. Boscaro M, Sonino N, Scarda A, et al: Anticoagulant prophylaxis markedly reduces thromboembolic complications in Cushing's syndrome. J Clin Endocrinol Metab 2002; 87:3662-3666
18. Sarlis NJ, Chanock SJ, Nieman LK: Corti-solemic indices predict severe infections in Cushing syndrome due to ectopic production of adrenocorticotropin. J Clin Endocrinol Metab 2000; 85:42-47
19. Graham BS, Tucker WS Jr: Opportunistic infections in endogenous Cushing's syndrome. Ann Intern Med 1984; 101:334-338
20. Zed PJ, Mabasa VH, Slavik RS, et al: Etomidate for rapid sequence intubation in the emergency department: Is adrenal suppression a concern? Can J Emerg Med 2006; 8:347-350
21. Murray H, Marik PE: Etomidate for endotra-cheal intubation in sepsis: Acknowledging the good while accepting the bad. Chest 2005; 127:707-709
22. Jackson WL Jr: Should we use etomidate as an induction agent for endotracheal intuba-tion in patients with septic shock: A critical appraisal. Chest 2005; 127:1031-1038
23. Guldner G, Schultz J, Sexton P, et al: Etomidate for rapid-sequence intubation in young children: Hemodynamic effects and adverse events. Acad Emerg Med 2003; 10: 134-139
24. Lundy JB, Slane ML, Frizzi JD: Acute adrenal insufficiency after a single dose of etomidate. J Intensive Care Med 2007; 22:111-117 (Pubitemid 46548132)
25. Ostwald P, Doenicke AW: Etomidate revisited. Curr Opin Anaesthesiol 1998; 11: 391-398
26. Zuckerbraun NS, Pitetti RD, Herr SM, et al: Use of etomidate as an induction agent for rapid sequence intubation in a pediatric emergency department. Acad Emerg Med 2006; 13:602-609
27. Annane D: ICU physicians should abandon the use of etomidate! Intensive Care Med 2005; 31:325-326
28. den Brinker M, Hokken-Koelega AC, Hazelzet JA, et al: One single dose of etomidate negatively influences adrenocortical performance for at least 24 h in children with meningococcal sepsis. Intensive Care Med 2008; 34: 163-168
29. Den Brinker M, Joosten KF, Liem O, et al: Adrenal insufficiency in meningococcal sepsis: Bioavailable cortisol levels and impact of interleukin-6 levels and intubation with eto-midate on adrenal function and mortality. J Clin Endocrinol Metab 2005; 90:5110-5117
30. Annane D, Sébille V, Charpentier C, et al: Effect of treatment with low dose of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288: 862-871
31. Lipiner-Friedman D, Sprung CL, Laterre PF, et al; for the Corticus Study Group: Adrenal function in sepsis: The retrospective Cortices cohort study. Crit Care Med 2007; 35: 1012-1018
32. Sprung CL, Annane D, Keh D, et al; CORTI-CUS Study Group: Hydrocortisone therapy for patients with septic shock. N Engl J Med 2008; 358:111-124
33. Johnson TN, Canada TW: Etomidate use for Cushing's syndrome caused by an ectopic adrenocorticotropic hormone-producing Tumor. Ann Pharmacother 2007; 41:350-353