Abstract：Objective : To explore the effect of etomidate on relative adrenal insufficiency (RAI) and mortality in patients with mechanical ventilation. Methods : The patients receiving mechanical ventilation were divided into etomidate group and propofol group who respectively received the treatment of etomidate and propofol. The difference of the rates of RAI and mortality were compared between the two groups. Results : The rates of RAI (62.99% vs. 46.85%) and mortality (38.98% vs. 27.95%) in the etomidate group were significantly higher than that in the propofol group (P <0.05); the relative risk degree of RAI and mortality in the etomidate group were 1.34 and 1.39 folds of the propofol group respectively. After adjusting the age, gender, and acute physiology and chronic health status score, the relative risk degrees of RAI and mortality in the etomidate group were respectively 1.26 and 1.30 folds of the propofol group. Conclusion : The etomidate increased the rates of RAI and mortality in patients with mechanical ventilation.
[1] 张侃, 白洁, 张马忠, 等. 依托咪酯在危重症等特殊人群的安全性[J]. 国际麻醉学与复苏杂志, 2012, 33(7):498-500.
[2] 蒋留琴, 鲁彦斌. 依托咪酯乳剂对老年上腹部手术患者的肾上腺皮质功能的影响[J]. 贵阳医学院学报, 2013, 38(5):531-532.
[3] Sunshine J E, Deem S, Weiss N S, et al. Etomidate, adrenal function,and mortality in critically ill patients[J]. Respir Care, 2013,58(4):639-646.
[4] Sprung C L, Annane D, Keh D，et al.Hydrocortisone therapy for patients with septic shock[J].N Engl J Med, 2008, 358(2): 111-124．
[5] Dmello D, Taylor S, O’Brien J, et al. Outcomes of etomidate in severe sepsis and septic shock[J]. Chest, 2010,138(6):1327-1332.
[6] Riche’F C, Boutron C M, Valleur P, et al. Adrenal response in patients with septic shock of abdominal origin: relationship to survival[J]. Intensive Care Med, 2007, 33(10): 1761-1766.
2016, Vol. 14 
