Etomidate and relative adrenal insufficiency in cardiopulmonary bypass surgery: impact on the postoperative hemodynamic status
© BioMed Central Ltd 2008
Published: 13 March 2008
Use of etomidate in cardiopulmonary bypass (CPB) surgery is usual practice during the anesthetic induction. The objective of this study was to determine the incidence of relative adrenal insufficiency (RAI) in CPB patients after etomidate administration and the impact on hemodynamic status.
A prospective cohort study was performed on CPB patients who received etomidate or not during the anesthetic induction. Patients were excluded if they had received systemic or inhaled corticosteroids or immunosuppressants, and active preoperative infection. RAI was defined as a rise in serum cortisol ≤ 9 μg/dl after the administration of 250 μg cosyntropin. Cortisol levels were measured preoperatively, immediately before and 30 minutes, 60 minutes and 90 minutes after the administration of cosyntropin (250 μg). We used SPSS version 15.
Incidence of relative adrenal insufficiency
Etomidate (n = 47)
Others (n = 18)
The use of etomidate was associated with RAI post CPB surgery. Cortisol levels were related to the postoperative hemodynamic profile and the need for vasopressor drugs.
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