Abstract
PurposeTo characterize risk factors for mortality in septic patients who received etomidate for rapid sequence intubation. Materials and MethodsThis 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. ResultsA 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. ConclusionAn alternative sedative induction agent may be considered for use in rapid sequence intubation in patients on multiple vasopressors or with abdominal source of infection.
Published Version
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