Risk factors for mortality in septic patients who received etomidate Journal Article

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Authors: Rech, M. A.; Bennett, S; Chaney, W; Sterk, E
Article Title: Risk factors for mortality in septic patients who received etomidate
Abstract: PURPOSE: To characterize risk factors for mortality in septic patients who received etomidate for rapid sequence intubation. MATERIALS AND METHODS: This study was a retrospective cohort conducted at a large, tertiary, urban, academic medical center that included patients with severe sepsis or septic shock who received etomidate between January 1, 2010, and December 31, 2012. RESULTS: A total of 169 patients were included with similar baseline characteristics. There were more men in the nonsurvivor group than in the survivor group (67.1% vs 50.6%, P = .03). Septic shock occurred in 91.5% of nonsurvivors and 69% of survivors (P .01). Nonsurvivors also had a higher initial lactate of (5.1 +/- 4.3 mmol/L vs 3.6 +/- 3.4 mmol/L, P = .02) and more vasopressor therapy (91.5% vs 69%, P .01), required a higher number of vasopressors (2.2 +/- 1.1 vs 1.3 +/- 1, P .01), and were administered hydrocortisone (53.7% vs 34.5%, P = .01). Abdominal source of sepsis (P = .048) and number of vasopressors (P = .01) were predictive of 30-day mortality. CONCLUSION: An alternative sedative induction agent may be considered for use in rapid sequence intubation in patients on multiple vasopressors or with abdominal source of infection.
Journal Title: The American Journal of Emergency Medicine
Volume: 33
Issue: 10
ISSN: 1532-8171; 0735-6757
Publisher: Unknown  
Date Published: 2015
Start Page: 1340
End Page: 1343
Language: ENG
DOI/URL:

S0735-6757(15)00618-X
Notes: LR: 20150901; CI: Copyright (c) 2015; JID: 8309942; 2015/05/17 [received]; 2015/07/17 [revised]; 2015/07/28 [accepted]; aheadofprint