title: The effect of single-bolus etomidate on septic patient mortality: a retrospective review.
abstract: BACKGROUND
  Because of its many desirable properties, etomidate is widely used as an induction agent for endotracheal intubation. However, some have recently called into question the safety of etomidate for even single-bolus use due to its known effects on adrenal suppression.
  
  
  OBJECTIVE
  We sought to compare the in-hospital mortality between septic patients given etomidate and those given alternative induction agents for intubation.
  
  
  METHODS
  We performed a retrospective chart review of intubated septic patients treated in our hospital. We collected data from patients over the age of 18 with sepsis who were intubated in the pre-hospital setting, in our emergency department, or on the wards of our hospital, and calculated the in-hospital mortality of each group.
  
  
  RESULTS
  We identified 181 patients with sepsis who were intubated over the study period; 135 received etomidate and 46 received alternative agents or no induction agent. Baseline characteristics, vital signs, and laboratory values were similar between the two groups. Of the 46 patients receiving alternative agents or no agent, 18 died, yielding an unadjusted mortality of 39.1% (95% CI 25.5% to 54.6%), while of the 135 patients receiving etomidate, 63 died, for an unadjusted mortality of 46.7% (95% CI 38.1% to 55.4%), P=0.38.
  
  
  CONCLUSIONS
  We found a non-statistically significant 7.6% absolute increase in mortality in patients given etomidate in our small-sized study population.
authors: Advocate Christ Medical Center, Department of Emergency Medicine.
authors: Karis L
authors: KL
authors: Tekwani
authors: Hannah F
authors: HF
authors: Watts
authors: Cindy W
authors: CW
authors: Chan
authors: Steve
authors: S
authors: Nanini
authors: Kathleen H
authors: KH
authors: Rzechula
authors: Erik B
authors: EB
authors: Kulstad