依托咪酯在危重症等特殊人群的安全性

Safety of the etomidate in the special populations such as critically ill patients

背景肾上腺皮质功能和患者的生存率密切相关，单剂量静脉注射依托咪酯引起可逆性的肾上腺皮质功能不全，因此，依托咪酯的安全性越来越受到重视。目的评价依托咪酯在临床应用中对肾上腺皮质功能的作用。内容肾上腺皮质功能不全相关的概念和诊断方法，以及使用依托咪酯后引起的皮质醇分泌减少在儿童和成年人，危重症和择期手术患者中产生的影响。趋势依托咪酯是否增加了危重症患者的死亡率存有争议。在择期手术的患者中，依托咪酯的安全性还需要得到多中心、前瞻性研究的论证。

Background Survival rate of patients is associated with the function of the adrenal cortex. Single dose iv injection of etomidate can induce reversible adrenal insufficiency. Thus, more and more attention is focused on the safety of etomidate. Objective To evaluate the effect of etomidate in clinical application on the function of adrenal cortex. Content This paper disscussed the concept and diagnosis of adrenal insufficiency, the effects of etomidate-induced adrenal insufficiency on children, adults, the critically ill and the patients undergoing elective surgeries. Trend Whether etomidate increases mortality in critically ill patients is controversial. The safety of etomidate in the population undergoing elective surgeries remains to be demonstrated by further multi-center and prospective studies.