Etomidate Does Not Increase Mortality in Patients with Sepsis

A meta-analysis finds no evidence of harm.

Etomidate causes laboratory abnormalities, specifically, suppression of cortisol production. Prior authors have attempted to demonstrate corresponding patient harm (NEJM JW Emerg Med Jan 16 2014). A new meta-analysis of two randomized, controlled trials and 16 observational studies involving 5552 patients helps us to draw conclusions from the totality of the evidence.

Pooled analysis revealed that single-dose etomidate increased risk for laboratory evidence of adrenal insufficiency (relative risk, 1.4), but did not significantly increase risk for mortality.

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Etomidate Does Not Increase Mortality in Patients with Sepsis

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Reviewing Author