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Master Thesis

Opothérapie par hydrocortisone après injection unique d'étomidate chez le patient de réanimation

Abstract : Objective : To evaluate the hemodynamic effect of an hydrocortisone traitement until the 48st hour after Etomidate administration to facilitate endotracheal intubation for patients with vital distress. Study Design: Placebo-controlled, randomized, double blinded, monocenter, in intention to treat study. Patients and Methods: 49 patients received placebo and 48 received 200 mg of hydrocortisone continuously during 42 hours after etomidate administration. Corticotropin test was performed 5 hours after etomidate administration. Etomidate-related adrenal inhibition was defined by the combination of a rise in cortisol less than 250 nmol/l (9 μg/dl) after ACTH stimulation and an excessive accumulation of serum 11β-deoxycortisol concentrations (> 8nmol/l) at baseline. Results: The number of patients requiring vasopressive therapy was not statistically different between the two groups. Durations of vasopressor therapy, mechanical ventilation, ICU lenght of stay, and mortality at day 28 were similar. The reduction of Norepinephrine dose was significantly greater in the hydrocortisone group than in the placebo group during the 42 hours of traitement. Episodes of superinfection were similar. Blood glucose levels were higher in the hydrocortison group but proportions of patients needed insulin were similar. Conclusion: Hydrocortison traitement after etomidate administration to facilitate endotracheal intubation for patients with vital distress during the first 48 hours does not significantly improve the hemodynamic status of these patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00624747
Contributor : Jean-Hugues Morneau <>
Submitted on : Thursday, May 17, 2012 - 5:04:52 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
Long-term archiving on: : Saturday, August 18, 2012 - 2:20:11 AM

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  • HAL Id : dumas-00624747, version 1

Citation

Clément Dupuis. Opothérapie par hydrocortisone après injection unique d'étomidate chez le patient de réanimation. Médecine humaine et pathologie. 2010. ⟨dumas-00624747⟩

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