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Debate continues about the nature, extent, and meaning of etomidate-induced adrenal insufficiency (Journal Watch Emergency Medicine Feb 1 2008). These authors retrospectively analyzed prospectively collected data from a trauma registry to determine risk factors for development of adrenal insufficiency in critically ill trauma patients.
The authors identified 137 patients who underwent cosyntropin stimulation testing (CST) at a single level I trauma center in 2002 through 2004 and who did not have histories of adrenal insufficiency or long-term corticosteroid use. Of these patients, 96% were intubated and 61% were classified as CST nonresponders. Patients were defined as being exposed to etomidate if they received etomidate 24 or more hours b…