Another Retrospective Observational Study Criticizes Etomidate

Yet another attempt to use retrospective methods to discredit a valuable medication.

Etomidate is one of the standard agents for induction during rapid sequence intubation when cardiovascular stability is a concern, because it causes minimal hypotension and has a very short duration of action. Randomized trials have not found it to cause any problems (NEJM JW Emerg Med Dec 17 2010 and NEJM JW Emerg Med Jul 2 2009), but a number of observational studies and secondary analyses have associated its use with increased morbidity, even death.

In a retrospective analysis of a database of patients who underwent general anesthesia for surgery at the Cleveland Clinic, researchers compared outcomes between 2144 patients who received etomidate and 5233 who received propofol. Only American Society of Anesthesiologists Class III and IV pat…

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

Another Retrospective Observational Study Criticizes Etomidate

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Reviewing Author