依托咪酯用于脓毒症或脓毒性休克患者的插管——我们接下来该何去何从？
Etomidate for intubation of patients who have sepsis or septic shock--where do we go from here?
作者信息
Griesdale Donald E G
出版信息
Crit Care. 2012 Dec 27;16(6):189. doi: 10.1186/cc11889.
Abstract
Etomidate is an intravenous induction agent that is associated with hemodynamic stability during intubation. The agent is therefore attractive for use in critically ill patients who have a high risk of hemodynamic instability during this procedure. However, etomidate causes adrenal suppression, which itself has been associated with increased mortality in critically ill patients. The ongoing debate surrounding use of etomidate is thus centered on the immediate favorable hemodynamic profile versus the long-term risks of adrenal insufficiency, particularly in patients who have severe sepsis or septic shock.
摘要
依托咪酯是一种静脉诱导剂，在插管过程中与血流动力学稳定性相关。因此，该药物对于在此过程中存在血流动力学不稳定高风险的重症患者具有吸引力。然而，依托咪酯会导致肾上腺抑制，而这本身与重症患者死亡率增加有关。因此，围绕依托咪酯使用的持续争论集中在其即时有利的血流动力学特征与肾上腺功能不全的长期风险之间，尤其是在患有严重脓毒症或脓毒性休克的患者中。
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Etomidate for intubation of patients who have sepsis or septic shock--where do we go from here?依托咪酯用于脓毒症或脓毒性休克患者的插管——我们接下来该何去何从？
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本文引用的文献
1
Effects of etomidate on complications related to intubation and on mortality in septic shock patients treated with hydrocortisone: a propensity score analysis.依托咪酯对接受氢化可的松治疗的脓毒症休克患者插管相关并发症及死亡率的影响：一项倾向评分分析
Crit Care. 2012 Nov 21;16(6):R224. doi: 10.1186/cc11871.
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The effects of etomidate on adrenal responsiveness and mortality in patients with septic shock.依托咪酯对感染性休克患者肾上腺反应性和死亡率的影响。
Intensive Care Med. 2009 Nov;35(11):1868-76. doi: 10.1007/s00134-009-1603-4. Epub 2009 Aug 4.
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Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial.依托咪酯与氯胺酮用于急重症患者快速顺序诱导插管的多中心随机对照试验
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Hydrocortisone therapy for patients with septic shock.氢化可的松治疗感染性休克患者。
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Duration of adrenal inhibition following a single dose of etomidate in critically ill patients.危重症患者单次给予依托咪酯后肾上腺抑制的持续时间。
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Intubating conditions and hemodynamic effects of etomidate for rapid sequence intubation in the emergency department: an observational cohort study.急诊科依托咪酯用于快速顺序插管的插管条件及血流动力学效应：一项观察性队列研究
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Etomidate and intensive care physicians.依托咪酯与重症监护医师。
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Risk factors of relative adrenocortical deficiency in intensive care patients needing mechanical ventilation.需要机械通气的重症监护患者相对肾上腺皮质功能不全的危险因素。
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Effects of thiopentone, etomidate and propofol on the haemodynamic response to tracheal intubation.硫喷妥钠、依托咪酯和丙泊酚对气管插管血流动力学反应的影响。
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