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Related Experiment Videos

Sedating ventilated asthmatics: etomidate reconsidered.

J R Eason1, C S Waldman, P S Sebel

  • 1Department of Anesthetics, Kings College Hospital, Denmark Hill, London.

Acta Anaesthesiologica Belgica
|January 1, 1988
PubMed
Summary
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Etomidate and fentanyl infusions were used for sedation in ventilated patients. While asthmatics survived, non-asthmatics had increased mortality, suggesting careful patient selection for etomidate use.

Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Etomidate and fentanyl infusions were employed for sedation in mechanically ventilated patients.
  • The study population included asthmatic patients on high-dose steroids and non-asthmatic patients without steroid treatment.

Purpose of the Study:

  • To describe the use of etomidate and fentanyl/alfentanil infusions for sedation.
  • To evaluate the outcomes in asthmatic and non-asthmatic patients receiving these infusions.

Main Methods:

  • Infusion of etomidate combined with fentanyl or alfentanil for sedation.
  • Monitoring of patient survival and retrospective measurement of plasma cortisol levels.

Main Results:

  • All four asthmatic patients survived.

Related Experiment Videos

  • Two of the non-asthmatic patients died, and subnormal plasma cortisol levels were observed in some patients, particularly those not on steroids.
  • Adrenal suppression was noted in patients receiving etomidate infusions.

    • Conclusions:

    • Long-term etomidate administration was associated with excess mortality, leading to suspension of the technique.
    • Etomidate infusion may be considered for selected asthmatic patients if steroid replacement therapy is administered concurrently.