Academic Journal
Corticosteroid after etomidate in critically ill patients: A randomized controlled trial.
| العنوان: | Corticosteroid after etomidate in critically ill patients: A randomized controlled trial. |
|---|---|
| المؤلفون: | Payen, Jean-François, Dupuis, Clément, Trouve-Buisson, Thibaut, Vinclair, Marc, Broux, Christophe, Bouzat, Pierre, Genty, Céline, Monneret, Denis, Faure, Patrice, Chabre, Olivier, Bosson, Jean-Luc |
| المساهمون: | INSERM U836, équipe 5, Neuroimagerie fonctionnelle et perfusion cérébrale, Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Anesthésie Réanimation, Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, Pôle Anesthésie Réanimation, Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, ThEMAS, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire (HP2), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'endocrinologie, Supported in part by a grant from the Délégation Régionale de la Recherche Clinique 2008, Hôpital Michallon, Grenoble, France. |
| المصدر: | ISSN: 0090-3493. |
| بيانات النشر: | CCSD Lippincott, Williams & Wilkins |
| سنة النشر: | 2012 |
| المجموعة: | Université Grenoble Alpes: HAL |
| مصطلحات موضوعية: | adrenal insufficiency, critical care, etomidate, outcome, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] |
| الوصف: | International audience ; OBJECTIVE:: To investigate the effects of moderate-dose hydrocortisone on hemodynamic status in critically ill patients throughout the period of etomidate-related adrenal insufficiency. DESIGN:: Randomized, controlled, double-blind trial (NCT00862381). SETTING:: University hospital emergency department and three intensive care units. INTERVENTIONS:: After single-dose etomidate (H0) for facilitating endotracheal intubation, patients without septic shock were randomly allocated at H6 to receive a 42-hr continuous infusion of either hydrocortisone at 200 mg/day (HC group; n = 49) or saline serum (control group; n = 50). MEASUREMENTS AND MAIN RESULTS:: After completion of a corticotrophin stimulation test, serum cortisol and 11β-deoxycortisol concentrations were subsequently assayed at H6, H12, H24, and H48. Forty-eight patients were analyzed in the HC group and 49 patients in the control group. Before treatment, the diagnostic criteria for etomidate-related adrenal insufficiency were fulfilled in 41 of 45 (91%) and 38 of 45 (84%) patients in the HC and control groups, respectively. The proportion of patients with a cardiovascular Sequential Organ Failure Assessment score of 3 or 4 declined comparably over time in both HC and control groups: 65% vs. 67% at H6, 65% vs. 69% at H12, 44% vs. 54% at H24, and 34% vs. 45% at H48, respectively. Required doses of norepinephrine decreased at a significantly higher rate in the HC group compared with the control group in patients treated with norepinephrine at H6. No intergroup differences were found regarding the duration of mechanical ventilation, intensive care unit length of stay, or 28-day mortality. CONCLUSION:: These findings suggest that critically ill patients without septic shock do not benefit from moderate-dose hydrocortisone administered to overcome etomidate-related adrenal insufficiency. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/21926601; PUBMED: 21926601 |
| DOI: | 10.1097/CCM.0b013e31822d7938 |
| الاتاحة: | https://inserm.hal.science/inserm-00658789 https://inserm.hal.science/inserm-00658789v1/document https://inserm.hal.science/inserm-00658789v1/file/Payen_CCM_2011_Vediteur.pdf https://doi.org/10.1097/CCM.0b013e31822d7938 |
| رقم الانضمام: | edsbas.19BB6DAB |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/CCM.0b013e31822d7938 |
|---|