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Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Adrenergic Agonists: Therapeutic Uses01:30

Adrenergic Agonists: Therapeutic Uses

Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response01:15

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response

Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...

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Related Experiment Video

Updated: May 19, 2026

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock
07:48

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock

Published on: October 28, 2022

Etomidate, adrenal function, and mortality in critically ill patients.

Jacob E Sunshine1, Steven Deem, Noel S Weiss

  • 1University of Washington School of Medicine, Department of Epidemiology, Seattle, WA 98195-6340, USA. jesun@uw.edu

Respiratory Care
|August 22, 2012
PubMed
Summary

Etomidate use in critically ill patients may increase mortality risk. This study found a trend toward higher hospital mortality and corticosteroid insufficiency in etomidate recipients, highlighting the need for further research.

Keywords:
ICUadrenal functionetomidatemortalityrapid sequence inductionsepsis

Related Experiment Videos

Last Updated: May 19, 2026

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock
07:48

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock

Published on: October 28, 2022

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Intensive Care Unit (ICU) Management

Background:

  • Etomidate is a common induction agent for critically ill patients requiring mechanical ventilation.
  • Previous studies suggest a potential association between etomidate and increased mortality, but with limited statistical power.
  • The precise impact of etomidate on hospital mortality and clinical outcomes in this population remains uncertain.

Purpose of the Study:

  • To investigate the association between etomidate administration and in-hospital mortality in critically ill patients.
  • To evaluate the relationship between etomidate exposure and the development of critical illness-related corticosteroid insufficiency.
  • To provide precise statistical measures for these clinical outcomes.

Main Methods:

  • Retrospective cohort study of 824 mechanically ventilated patients from January 2001 to December 2005.
  • Comparison of in-hospital mortality between patients receiving etomidate (n=452) and alternative induction agents (n=372).
  • Secondary outcome assessed diagnosis of critical illness-related corticosteroid insufficiency following etomidate exposure.

Main Results:

  • Overall in-hospital mortality was 34.3%.
  • Adjusted analysis showed a higher relative risk of death for etomidate recipients (RR 1.20, 95% CI 0.99-1.45).
  • Etomidate exposure was associated with an increased adjusted risk of critical illness-related corticosteroid insufficiency (aRR 1.37, 95% CI 1.12-1.66).

Conclusions:

  • Etomidate administration in critically ill patients undergoing intubation showed a trend toward increased mortality.
  • The findings align with smaller randomized trials but suggest a potentially considerable absolute increase in deaths in this high-risk group.
  • Large, prospective controlled trials are necessary to definitively establish etomidate's role in critically ill patients.