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Table 1 Summary of recent randomized controlled trials of etomidate

From: Pro/con debate: Is etomidate safe in hemodynamically unstable critically ill patients?

Study

N

Intervention

Subjects

Main outcomes

Absalom et al. 1999 [32]

35

Etomidate versus thiopentone

ASA III, two or more organ failures

Etomidate may interfere with cortisol synthesis for at least 24 hours

Schenarts et al. 2001 [33]

18

Etomidate versus midazolam

Emergency department patients requiring intubation

CST significantly different at 4 hours, same response at 12 and 24 hours

Hildreth et al. 2008 [34]

30

Etomidate versus midazolam and fentanyl

Trauma patients requiring intubation

Chemical evidence of AI and may have contributed to increased hospital and ICU lengths of stay

Jabre et al. 2009 [3]

469

Etomidate versus ketamine

Emergency department patients requiring intubation

No difference in 28 day morbidity or mortality

Tekwani et al. 2010 [35]

122

Etomidate versus midazolam

Emergency department suspected sepsis requiring intubation

No difference in mean hospital length of stay, ventilator days, ICU stay or in-hospital mortality

Morel et al. 2011 [36]

100

Etomidate versus propofol

Elective cardiac surgery

Etomidate blunts the HPA for more than 24 hours, no associated increase in vasopressor requirements

  1. AI adrenal insufficiency; ASA, American Society of Anesthesiologists; CST, corticotrophin stimulation test; HPA, hypothalamic pituitary axis.