|
KMID : 0356920210740040300
|
|
Korean Journal of Anesthesiology
2021 Volume.74 No. 4 p.300 ~ p.307
|
|
|
Effects of etomidate use in ICU patients on ventilator therapy: a study of 12,526 patients in an open database from a single center
|
|
Park Ha-Yeon
Lee Youn-Suk
Lim Chi-Yeon
Kim Mina
Park Ji-Eun
Lee Teak-Seon
|
|
|
Abstract
|
|
|
Background: There is a debate regarding the safety of etomidate. We evaluated the effects of etomidate on mortality in a large cohort of critical care patients.
Methods: This retrospective matched-cohort study was performed using the Medical Information Mart for Intensive Care version 3 (MIMIC-III) database. Among 12,526 adult patients who were prescribed etomidate or propofol on the first day of mechanical ventilation, 625 patients administered etomidate were statistically matched with 6,250 patients administered propofol. The primary outcome measures were all-cause in-hospital mortality, 48-hour survival, cardiovascular morbidity, and infectious morbidity. Logistic regression analysis with stepwise selection of variables was performed to examine the dose?mortality relationship of etomidate.
Results: All-cause in-hospital mortality was 1.84 times higher in the etomidate cohort (OR: 1.84, 98.75% CI: 1.42, 2.37). Compared to the propofol cohort, the etomidate cohort showed 57% lower odds of 48-hour survival (0.43 [0.27, 0.73]), no difference in odds of cardiovascular morbidity (0.86 [0.66, 1.12]), and 1.77 times higher odds of infectious morbidity (1.77 [1.35, 2.31]). Additionally, the odds of mortality increased by 1.36 times per 0.1 mg/kg of etomidate (1.36 [95% CI: 1.23, 1.49]).
Conclusions: Etomidate is a poor choice as a hypnotic drug on the first day of mechanical ventilation, as it is associated with a dose-dependent increase in all-cause mortality, and does not improve survival for the first 48 h.
|
|
|
KEYWORD
|
|
|
Dose-response relationship, Etomidate, Intensive care unit, Mortality, Propofol, Ventilator
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
   
|
|