Haemodynamic consequences of etomidate administration in elective cardiac surgery: A randomized double-blinded study

British Journal of Anaesthesia

Volumn 107, Issue 4, 2011, Pages 503-509

  Morel, J ^a   Salard, M ^a   Castelain, C ^a   Bayon, M C ^a   Lambert, P ^a   Vola, M ^a   Auboyer, C ^a   Molliex, S ^a  

^a UNIVERSITY HOSPITAL OF SAINT ETIENNE   (France)

Author keywords

Adrenal insufficiency; cardiac surgical procedures; etomidate cardiovascular agents, vasopressor agents

Indexed keywords

APROTININ; CISATRACURIUM; DESFLURANE; DOBUTAMINE; ETOMIDATE; HEPARIN; HYDRAZINE; KETOPROFEN; LIPURO; MIDAZOLAM; NORADRENALIN; PARACETAMOL; PROPOFOL; PROPOFOL FRESENIUS; SUFENTANIL; TETRACOSACTIDE; TRAMADOL; TRANEXAMIC ACID; UNCLASSIFIED DRUG;

ADRENAL INSUFFICIENCY; ADULT; AGED; ANESTHESIA INDUCTION; ARTICLE; CARDIOPULMONARY BYPASS; CONTINUOUS INFUSION; CORTICOTROPIN TEST; DOUBLE BLIND PROCEDURE; DRUG DOSE TITRATION; DRUG SUBSTITUTION; DRUG WITHDRAWAL; ELECTIVE SURGERY; FEMALE; HEART HEMODYNAMICS; HEART SURGERY; HUMAN; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; INCIDENCE; MAJOR CLINICAL STUDY; MALE; POSTOPERATIVE PERIOD; PRIORITY JOURNAL; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL;

EID: 80052617590     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aer169     Document Type: Article

References (32)

1. Annane D. ICU physicians should abandon the use of etomidate!. Intensive Care Med 2005; 31: 325-6
2. Jackson WL Jr. Should we use etomidate as an induction agent for endotracheal intubation in patients with septic shock? A critical appraisal. Chest 2005; 127: 1031-8 (Pubitemid 40775537)
3. Wagner RL, White PF. Etomidate inhibits adrenocortical function in surgical patients. Anesthesiology 1984; 61: 647-51 (Pubitemid 15223411)
4. Bloomfield R, Noble DW. Etomidate and fatal outcome-even a single bolus dose may be detrimental for some patients. Br J Anaesth 2006; 97: 116-7
5. Jaber S, Jung B, Corne P, et al. An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Intensive Care Med 2010; 36: 248-55
6. Cuthbertson BH, Sprung CL, Annane D, et al. The effects of etomidate on adrenal responsiveness and mortality in patients with septic shock. Intensive Care Med 2009; 35: 1868-76
7. Lipiner-Friedman D, Sprung CL, Laterre PF, et al. Adrenal function in sepsis: the retrospective Corticus cohort study. Crit Care Med 2007; 35: 1012-8 (Pubitemid 46598949)
8. Kenyon CJ, McNeil LM, Fraser R. Comparison of the effects of etomidate, thiopentone and propofol on cortisol synthesis. Br J Anaesth 1985; 57: 509-11 (Pubitemid 15052541)
9. Ray DC, Hay AW, McKeown DW. Induction drug and outcome of patients admitted to the intensive care unit after emergency laparotomy. Eur J Anaesthesiol 2010; 27: 481-5
10. Jabre P, Combes X, Lapostolle F, et al. Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. Lancet 2009; 374: 293-300
11. Hoda MR, El-Achkar H, Schmitz E, Scheffold T, Vetter HO, De Simone R. Systemic stress hormone response in patients undergoing open heart surgery with or without cardiopulmonary bypass. Ann Thorac Surg 2006; 82: 2179-86
12. Donmez A, Kaya H, Haberal A, Kutsal A, Arslan G. The effect of etomidate induction on plasma cortisol levels in children undergoing cardiac surgery. J Cardiothorac Vasc Anesth 1998; 12: 182-5
13. Duthie DJ, Fraser R, Nimmo WS. Effect of induction of anaesthesia with etomidate on corticosteroid synthesis in man. Br J Anaesth 1985; 57: 156-9 (Pubitemid 15093403)
14. Henzen C, Kobza R, Schwaller-Protzmann B, Stulz P, Briner VA. Adrenal function during coronary artery bypass grafting. Eur J Endocrinol 2003; 148: 663-8 (Pubitemid 36758297)
15. Seravalli L, Pralong F, Revelly JP, Que YA, Chollet M, Chiolero R. Adrenal function after induction of cardiac surgery patients with etomidate: a retrospective study. Ann Fr Anesth Reanim 2009; 28: 743-7
16. Absalom A, Pledger D, Kong A. Adrenocortical function in critically ill patients 24 h after a single dose of etomidate. Anaesthesia 1999; 54: 861-7 (Pubitemid 29415418)
17. Stuttmann R, Allolio B, Becker A, Doehn M, WinkelmannW. Etomidate versus etomidate and hydrocortisone for anesthesia induction in abdominal surgical interventions. Anaesthesist 1988; 37: 576-82
18. Gooding JM, Weng JT, Smith RA, Berninger GT, Kirby RR. Cardiovascular and pulmonary responses following etomidate induction of anesthesia in patients with demonstrated cardiac disease. Anesth Analg 1979; 58: 40-1 (Pubitemid 9153433)
19. Sprung J, Ogletree-Hughes ML, Moravec CS. The effects of etomidate on the contractility of failing and nonfailing human heart muscle. Anesth Analg 2000; 91: 68-75 (Pubitemid 30437063)
20. Laffey JG, Boylan JF, Cheng DC. The systemic inflammatory response to cardiac surgery: implications for the anesthesiologist. Anesthesiology 2002; 97: 215-52 (Pubitemid 34733943)
21. Serrano CV Jr, Souza JA, Lopes NH, et al. Reduced expression of systemic proinflammatory and myocardial biomarkers after off-pump versus on-pump coronary artery bypass surgery: a prospective randomized study. J Crit Care 2010; 25: 305-12
22. Fergusson DA, Hebert PC, Mazer CD, et al. A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. N Engl J Med 2008; 358: 2319-31 (Pubitemid 351749156)
23. Annane D, Sebille V, Troche G, Raphael JC, Gajdos P, Bellissant E. A 3-level prognostic classification in septic shock based on cortisol levels and cortisol response to corticotropin. J Am Med Assoc 2000; 283: 1038-45 (Pubitemid 30112218)
24. Cremer J, Martin M, Redl H, et al. Systemic inflammatory response syndrome after cardiac operations. Ann Thorac Surg 1996; 61: 1714-20 (Pubitemid 26179719)
25. Kilger E, Weis F, Briegel J, et al. Stress doses of hydrocortisone reduce severe systemic inflammatory response syndrome and improve early outcome in a risk group of patients after cardiac surgery. Crit Care Med 2003; 31: 1068-74 (Pubitemid 36444415)
26. Iribarren JL, Jimenez JJ, Hernandez D, et al. Relative adrenal insufficiency and haemodynamic status in cardiopulmonary bypass surgery patients. A prospective cohort study. J Cardiothorac Surg 2010; 5: 26-30
27. Brander L, Haltmeier T, Suter A, et al. Peri-operative adrenocortical response to low-dose (1 microg) ACTH and relation to postoperative complications in patients undergoing elective abdominal surgery. Surgery 2009; 146: 88-99
28. Cooper MS, Stewart PM. Corticosteroid insufficiency in acutely ill patients. N Engl J Med 2003; 348: 727-34 (Pubitemid 36237043)
29. Vinclair M, Broux C, Faure P, et al. Duration of adrenal inhibition following a single dose of etomidate in critically ill patients. Intensive Care Med 2008; 34: 714-9 (Pubitemid 351660088)
30. Yeager MP, Rassias AJ, Fillinger MP, et al. Cortisol antiinflammatory effects are maximal at postoperative plasma concentrations. Crit Care Med 2005; 33: 1507-12 (Pubitemid 40980605)
31. Cotton BA, Guillamondegui OD, Fleming SB, et al. Increased risk of adrenal insufficiency following etomidate exposure in critically injured patients. Arch Surg 2008; 143: 62-7; discussion 67 (Pubitemid 351159292)
32. Hildreth AN, Mejia VA, Maxwell RA, Smith PW, Dart BW, Barker DE. Adrenal suppression following a single dose of etomidate for rapid sequence induction: a prospective randomized study. J Trauma 2008; 65: 573-9