Effect of use of single dose of Etomidate on serum cortisol levels in patients requiring rapid sequence intubation in ED (ETOCORT trial):An Observational Study

Rapid sequence intubation is a critical and time sensitive procedure performed in emergency departments. It involves administration of an induction agent and a paralytic agent to facilitate rapid tracheal intubation. Etomidate is frequently chosen due to its rapid onset and short duration and minimal cardiovascular effects. But it also inhibits cortisol synthesis thereby reducing the cortisol’s levels. Cortisol plays a pivotal role in body’s stress response thereby maintaining blood pressure, metabolism and immune function. The above effect of etomidate led to a growing body of literature examining the clinical implications of its use, particularly in those patients who are susceptible to adrenal insufficiency, for example, sepsis, burns and polytrauma.

This study, therefore aims to investigate the effect of a single dose of Etomidate on cortisol levels in patients undergoing rapid sequence intubation in the ED and thereby evaluating the extent of cortisol suppression and its actual clinical implications