Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock.

Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Abstract Text:

David Charles Ray,Dermot William McKeown,David Charles Ray,Dermot William McKeown,

INTRODUCTION: In seriously ill patients, etomidate gives cardiovascular stability at induction of anaesthesia, but there is concern over possible adrenal suppression. Etomidate could reduce steroid synthesis and increase the need for vasopressor and steroid therapy. The outcome could be worse than in patients given other induction agents. METHODS: We reviewed 159 septic shock patients admitted to our intensive care unit (ICU) over a 40-month period to study the association between induction agent and clinical outcome, including vasopressor, inotrope, and steroid therapy. From our records, we retrieved induction agent use; vasopressor administration at induction; vasopressor, inotrope, and steroid administration in the ICU; and hospital outcome. RESULTS: Hospital mortality was 65%. The numbers of patients given an induction agent were 74, etomidate; 25, propofol; 26, thiopental; 18, other agent; and 16, no agent. Vasopressor, inotrope, or steroid administration and outcome were not related to the induction agent chosen. Corticosteroid therapy given to patients who received etomidate did not affect outcome. Vasopressor therapy was required less frequently and in smaller doses when etomidate was used to induce anaesthesia. We found no evidence that either clinical outcome or therapy was affected when etomidate was used. Etomidate caused less cardiovascular depression than other induction agents in patients with septic shock. CONCLUSION: Etomidate use for critically ill patients should consider all of these issues and not simply the possibility of adrenal suppression, which may not be important when steroid supplements are used.

Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Publishing Authors By Initials

DC Ray,DW McKeown,DC Ray,DW McKeown,

For similar abstracts research abstracts see: abstracts research

PUBMED ID PMID:

MEDLINE DATE:

Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Critical care (London, England)

VOLUME: 11

Page Numbers: R56

Journal Abbreviation:

ISSN: 1466-609X

DAY: 16

MONTH: 01

YEAR: 2007

Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 9801902

Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Keywords Mesh Terms:

KEYWORDS:

MESH TERMS:

Chemical & Substance for Abstract: Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock.

AFFILIATION: Department of Anaesthesia, Critical Care & Pain Medicine, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, Scotland, UK. david.ray@luht.scot.nhs.uk

Country: England

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Crit Care

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock Related Publications

• "Extra-ordinary" ergonomics: how to accommodate small and big persons, the disabled and elderly, expectant mothers, and children.
• A Framework for Group Analysis of fMRI Data using Dynamic Bayesian Networks.
• A double-switch system regulates male courtship behavior in male and female Drosophila melanogaster.
• A guide to human factors and ergonomics.
• American medical services.
• An attempted suicide when hypoglycaemic.
• An examination of the work of local-authority child-welfare clinics.
• Arterial pressure in an industrial population; and its bearing on the problem of essential hypertension.
• Bayesian network modeling for discovering "dependent synergies" among muscles in reaching movements.
• Cardiovascular disease risk profiles among 'healthy' siblings of patients with early-onset cardiovascular disease: application of the new SCORE system.
• Characterizing task-related temporal dynamics of spatial activation distributions in fMRI BOLD signals.
• Dynamic Bayesian network modeling of fMRI: A comparison of group-analysis methods.
• Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock.
• Evaluation of the Antiangiogenic Potential of AQ4N.
• Fetal distress: lessons of the fetal electrocardio-gram.
• Frequency Dependence in a Liquid's Complex Refractive Index Measured with Infrared Spectroradiometry.
• Getting a second opinion: health information and the Internet.
• Hidden Markov Multivariate Autoregressive (HMM-mAR) Modeling Framework for Surface Electromyography (sEMG) Data.
• Invariant SPHARM Shape Descriptors for Complex Geometry in MR Region of Interest Analysis.
• Joint spatial denoising and active region of interest delineation in functional magnetic resonance imaging.
• Laryngoscopic views during rapid sequence intubation in the emergency department.
• MSI-H 'medullary type' adenocarcinoma complicating ileal Crohn's disease; further molecular insight into Crohn's-related carcinogenesis.
• Mental health advocacy with black and minority ethnic communities: conceptual and ethical implications.
• Oat-cell carcinoma of the oesophagus.
• Poverty, race and crime.
• Sarcoidosis involving the heart; report of case with sudden death.
• Social medicine in the universities.
• Spectral Clustering of fMRI Data within Regions of Interest: Clarification of L-dopa effects in Parkinson's Disease.
• The utilization of medical resources.
• Use of the McGrath videolaryngoscope in the management of difficult and failed tracheal intubation.