Pro/con debate: Is etomidate safe in hemodynamically unstable critically ill patients?
1 Department of Intensive Care Medicine, Prince of Wales Hospital, Randwick, NSW, 2031 Australia
2 University of New South Wales Clinical School, Intensive Care Research, Prince of Wales Hospital, Randwick, NSW, 2031 Australia
Critical Care 2012, 16:227 doi:10.1186/cc11242Published: 19 July 2012
Etomidate is an induction agent known for its smooth intubating conditions and cardiovascular stability. Studies, however, have shown that a single dose of etomidate can result in a prolonged adrenal insufficiency. The impact of this in patients with sepsis has been a matter for debate. This review presents a pro/con case for using etomidate in hemodynamically unstable critically ill patients and provides guidance for alternative induction techniques and when the use of etomidate might be justified despite these concerns.