Kamp Ryan, Kress John P
University of Chicago Hospitals, S Maryland Avenue, Chicago, Illinois 60637, USA.
Crit Care. 2007;11(3):145. doi: 10.1186/cc5939.
The choice of induction agent for endotracheal intubation can have significant downstream effects, especially in critically ill patients. In a retrospective study, Ray and McKeown found that the choice of induction agent had no significant effect on use of vasoactive medications, corticosteroids, or mortality. Given the heated debate regarding corticosteroids in septic shock and the role that etomidate may play in leading to adrenal insufficiency, enthusiasm for etomidate as an induction agent should be tempered by its possible, significant side effects in these critically ill patients.
气管插管诱导药物的选择可能会产生重大的后续影响,尤其是在重症患者中。在一项回顾性研究中,雷和麦基翁发现诱导药物的选择对血管活性药物、皮质类固醇的使用或死亡率没有显著影响。鉴于关于脓毒性休克中皮质类固醇的激烈争论以及依托咪酯可能导致肾上腺功能不全的作用,在这些重症患者中,依托咪酯作为诱导药物的应用热情应因其可能产生的显著副作用而有所缓和。