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Despite repeated lack of evidence for clinical significance of the transient corticosteroid insufficiency associated with a single bolus of etomidate for rapid sequence intubation, controversy remains. To assess the effect of etomidate on incidence of hospital-acquired pneumonia, researchers analyzed data from the HYPOLYTE trial — a French multicenter randomized, double-blind, placebo-controlled trial of hydrocortisone in 149 intubated trauma patients who remained on ventilators for at least 48 hours (JW Hosp Med Apr 21 2011). Ninety-five patients received etomidate.
Corticotropin testing was performed in all patients before hydrocortisone or placebo administration (at least 8 hours after etomidate injection in etomidate recipients). Althoug…