Corticosteroid after etomidate in critically ill patients: a randomized controlled trial
| العنوان: | Corticosteroid after etomidate in critically ill patients: a randomized controlled trial |
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| المؤلفون: | Marc Vinclair, Jean François Payen, Pierre Bouzat, J.-L. Bosson, Denis Monneret, Thibaut Trouve-Buisson, Olivier Chabre, C. Broux, Patrice Faure, Clément Dupuis, Céline Genty |
| 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, CHU Grenoble-Hôpital Michallon-CHU Grenoble-Hôpital Michallon, Pôle Anesthésie Réanimation, CHU Grenoble-Hôpital Michallon, ThEMAS, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-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), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Hypoxie et physiopathologies cardiovasculaire et respiratoire, 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., 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 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), Dojat, Michel |
| المصدر: | Critical Care Medicine Critical Care Medicine, Lippincott, Williams & Wilkins, 2012, 40 (1), pp.29-35. ⟨10.1097/CCM.0b013e31822d7938⟩ Critical Care Medicine, 2012, 40 (1), pp.29-35. ⟨10.1097/CCM.0b013e31822d7938⟩ |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Adult, Male, Time Factors, Hydrocortisone, medicine.drug_class, Critical Illness, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Double-Blind Method, law, Etomidate, Intensive care, medicine, Adrenal insufficiency, Intubation, Intratracheal, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], 030212 general & internal medicine, Infusions, Intravenous, Septic shock, business.industry, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, Intensive care unit, 3. Good health, critical care, Anesthesia, outcome, Corticosteroid, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Female, business, Anesthetics, Intravenous, medicine.drug, Adrenal Insufficiency |
| 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. |
| وصف الملف: | application/pdf |
| تدمد: | 1530-0293 0090-3493 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c803a9ade659cacf0e110c4f48a43d81 https://pubmed.ncbi.nlm.nih.gov/22610230 |
| حقوق: | EMBARGO |
| رقم الأكسشن: | edsair.doi.dedup.....c803a9ade659cacf0e110c4f48a43d81 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15300293 00903493 |
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