Adrenocortical function in critically ill patients 24 h after a single dose of etomidate

✍ Scribed by Absalom; Pledger; Kong

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 117 KB
• Volume: 54
• Category: Article
• ISSN: 0003-2409
• DOI: 10.1046/j.1365-2044.1999.01003.x

✦ Synopsis

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.