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Adrenocortical function in critically ill patients 24 h after a single dose of etomidate
Author(s) -
Anthony Absalom,
D R Pledger,
Alice PikShan Kong
Publication year - 1999
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.1999.01003.x
Subject(s) - etomidate , medicine , critically ill , anesthesia , adrenocorticotropic hormone , hydrocortisone , hormone , general anaesthesia , adrenal insufficiency , stimulation , general anaesthetic , propofol
We compared the effects of single doses of etomidate and thiopentone on adrenocortical function in a randomised controlled clinical trial involving 35 critically ill patients who needed a general anaesthetic. Just before induction of anaesthesia, a baseline blood cortisol sample was taken. Twenty‐four hours later we performed a short adrenocorticotrophic hormone stimulation test. No patient had a low cortisol level (< 160 nmol.l −1 ) at any time during the study. Baseline, pre‐ACTH and post‐ACTH cortisol levels were similar in the two groups. However, significantly more patients in the etomidate group had an ACTH‐stimulated cortisol increment < 200 nmol.l −1 . The clinical significance of these findings is not clear, but we conclude that single doses of etomidate may interfere with cortisol synthesis for at least 24 h in the critically ill.