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• W2947646811 abstract "AbstractIntroduction Etomidate has a neutral hemodynamicprofile which has made it an attractive medication foremergent intubation. Despite theoretical advantages ofetomidate administration in the trauma patient, there areincomplete data to support its use. This study examined theassociation of etomidate use for emergent intubation intraumatic illness with patient mortality.Methods This is a historical cohort study using the NovaScotia Trauma Registry. It included all major adult traumapatients who required tracheal intubation at the QueenElizabeth II Health Sciences Centre in Halifax, Canadafrom January 23, 2000 to March 25, 2012. Prospectivelyrecorded data were analyzed, including patientdemographics, presence of comorbidities, trauma specificvariables, admission and discharge vitals, length of stay inthe intensive care unit (ICU) and hospital, mechanicalventilation-free days, and mortality. Associations betweenthe use of etomidate and 28-day mortality are presented asodds ratios. Multivariable logistic regression models werecreated adjusting for age, injury severity score (ISS), sex,comorbidities, presence of traumatic brain injury, andinjury type. The effects of etomidate on other relevantoutcome variables were assessed using unpaired Student’st-tests.Results Three hundred eight patients were included inthe study, and there were 42 deaths. Patients receivingetomidate were similar to those who did not, including ISSand pre-intubation blood pressure. The 28-day mortalitywas 18.7% in the etomidate group and 11.1% in the non-etomidate group (odds ratio = 1.85; 95% confidenceinterval [CI] 0.96 to 3.57; P = 0.07). After adjustment forage, female sex, ISS, and comorbidity, the odds ratio was1.94 (95% CI 0.87 to 4.37; P = 0.11). There were nodifferences between the two groups in ICU length of stay,hospital length of stay, or number of ventilation-free days.Conclusion The association between use of a single doseof etomidate for emergency tracheal intubation in thetrauma patient and mortality is inconclusive. Etomidateadministration should be used with caution in traumapatients requiring tracheal intubation. Further data arerequired to determine the safety and risk-benefit ofetomidate use in this patient population.Re´sume´Introduction L’e´tomidate a un profil he´modynamiqueneutre qui en fait un me´dicament inte´ressant pourl’intubation de cas d’urgence. Malgre´ les avantagesthe´oriques de l’administration de l’e´tomidate chez despatients atteints de trauma, il manque de donne´esprobantes pour encourager son utilisation. Cette e´tude aexamine´ l’association de l’utilisation de l’e´tomidate pourintubation en cas d’urgence avec la mortalite´ des patientspre´sentant des le´sions traumatiques.Me´thodes Il s’agit d’une e´tude de cohorte historiqueutilisant le Registre de traumatologie de Nouvelle-E´cosse." @default.
• W2947646811 created "2019-06-07" @default.
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• W2947646811 date "2014-01-01" @default.
• W2947646811 modified "2023-09-23" @default.
• W2947646811 title "The impact of etomidate on mortality in trauma patients L'impact de l'etomidate sur la mortalitedes patients atteints de trauma" @default.
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