Evidence map›Paper›PMID 22208901›Full record

Trial reportBMC clinical pharmacology2011

Etomidate and mortality in cirrhotic patients with septic shock.

Antoine J Cherfan, Hani M Tamim, Abdulrahman AlJumah, Asgar H Rishu, Abdulmajeed Al-Abdulkareem, Bandar A Al Knawy, Ali Hajeer, Waleed Tamimi, Riette Brits, Yaseen M Arabi

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC clinical pharmacology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Antoine J CherfanPharmaceutical Care Department, Clinical Pharmacy Division, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Hani M Tamim
Abdulrahman AlJumah
Asgar H Rishu
Abdulmajeed Al-Abdulkareem
Bandar A Al Knawy
Ali Hajeer
Waleed Tamimi
Riette Brits
Yaseen M Arabi
King Saud bin Abdulaziz University for Health Sciences · SAKing Abdulaziz Medical City · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical effects and outcomes of a single dose etomidate prior to intubation in the intensive care setting is controversial. The aim of this study is to evaluate the association of a single dose effect of etomidate prior to intubation on the mortality of septic cirrhotic patients and the impact of the subsequent use of low dose hydrocortisone.

methodsThis is a nested-cohort study within a randomized double blind placebo controlled study evaluating the use of low dose hydrocortisone in cirrhotic septic patients. Cirrhotic septic patients ≥ 18 years were included in the study. Patients who received etomidate prior to intubation were compared to those who did not receive etomidate for all cause 28-day mortality as a primary outcome.

resultsSixty two intubated patients out of the 75 patients randomized in the initial trial were eligible for this study. Twenty three of the 62 intubated patients received etomidate dose prior to intubation. Etomidate use was not associated with all cause 28-day mortality or hospital mortality but was associated with significantly higher ICU mortality (91% vs. 64% for etomidate and controls groups, respectively; p = 0.02). Etomidate patients who received subsequent doses of hydrocortisone required lower doses of vasopressors and had more vasopressor-free days but no improvement in mortality.

conclusionsIn this group of septic cirrhotic patients with very high mortality, etomidate increased ICU mortality. Subsequent use of hydrocortisone appears to have no benefit beyond decreasing vasopressor requirements. The lowest mortality was observed in patients who did not receive etomidate but received hydrocortisone.

Indexed as

Cohort StudiesDouble-Blind MethodEtomidateFemaleFibrosisHospital MortalityHumansHydrocortisoneIntensive Care UnitsIntubationMaleMiddle AgedShock, SepticTreatment OutcomeVasoconstrictor AgentsEtomidateHydrocortisoneVasoconstrictor Agents

Identifiers

PMID22208901
PMCPMC3295685
OpenAlexW2061611549

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.