Universität zu Köln

Gaessler, Michael, Ruppert, Matthias, Lefering, Rolf, Bouillon, Bertil and Wafaisade, Arasch (2019). Pre-hospital emergent intubation in trauma patients: the influence of etomidate on mortality, morbidity and healthcare resource utilization. Scand. J. Trauma Resusc. Emerg. Med., 27. LONDON: BMC. ISSN 1757-7241

Full text not available from this repository.

Abstract

BackgroundDue to its favorable hemodynamic characteristics and by providing good intubation conditions etomidate is often used for induction of general anesthesia in trauma patients. It has been linked to temporary adrenal cortical dysfunction. The clinical relevance of this finding after a single-dose is still lacking appropriate evidence.MethodsThis retrospective multi-centre study is based on merged data from a German Helicopter Emergency Medical Service (HEMS) database and a large trauma patient registry. All trauma patients who were intubated prior to hospital admission with a documented Injury Severity Score9 between 2008 and 2012 were eligible for analysis. The primary endpoint was hospital mortality. Other outcome measures were organ failures, sepsis, length of ventilation, as well as length of stay in hospital and ICU.ResultsOne thousand six hundred ninety seven patients were enrolled into the study. Seven hundred sixty two patients received etomidate and 935 patients received other induction agents. The in-hospital mortality was similar in both groups (18.9% versus 18.2%; p=0.71). Incidences of organ failures and sepsis were not increased in the etomidate group. However, health care resource utilization parameters were prolonged (after adjusting: +1.3days for ICU length of stay, p=0.062; +0.8days for length of ventilation, p=0.15; +2,7days for hospital length of stay, p=0.034). A multivariable logistic regression analysis did not identify etomidate as an independent predictor of hospital mortality (OR: 1.10, 95% CI: 0.77-1.57; p=0.60).ConclusionsThis is the largest trial investigating outcome data for trauma patients who had received a single-dose of etomidate for induction of anesthesia. The use of etomidate did not affect mortality. The influence on morbidity and health care resource utilization remains unclear.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gaessler, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruppert, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Lefering, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Bouillon, Bertil UNSPECIFIED UNSPECIFIED UNSPECIFIED Wafaisade, Arasch UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-138037
DOI:	10.1186/s13049-019-0637-z
Journal or Publication Title:	Scand. J. Trauma Resusc. Emerg. Med.
Volume:	27
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1757-7241
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RAPID-SEQUENCE INTUBATION; SINGLE-DOSE ETOMIDATE; KETAMINE; MULTICENTER; INHIBITION; INDUCTION; IMPACT; SCORE Multiple languages Emergency Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13803