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Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery—Results of a Retrospective, before–after Study
Background: Etomidate is typically used as an induction agent in cardiac surgery because it has little impact on hemodynamics. It is a known suppressor of adrenocortical function and may increase the risk for post-operative infections, sepsis, and mortality. The aim of this study was to evaluate whe...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269440/ https://www.ncbi.nlm.nih.gov/pubmed/34209919 http://dx.doi.org/10.3390/jcm10132908 |
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author | Weiss, Björn Schiefenhövel, Fridtjof Grunow, Julius J. Krüger, Michael Spies, Claudia D. Menk, Mario Kruppa, Jochen Grubitzsch, Herko Sander, Michael Treskatsch, Sascha Balzer, Felix |
author_facet | Weiss, Björn Schiefenhövel, Fridtjof Grunow, Julius J. Krüger, Michael Spies, Claudia D. Menk, Mario Kruppa, Jochen Grubitzsch, Herko Sander, Michael Treskatsch, Sascha Balzer, Felix |
author_sort | Weiss, Björn |
collection | PubMed |
description | Background: Etomidate is typically used as an induction agent in cardiac surgery because it has little impact on hemodynamics. It is a known suppressor of adrenocortical function and may increase the risk for post-operative infections, sepsis, and mortality. The aim of this study was to evaluate whether etomidate increases the risk of postoperative sepsis (primary outcome) and infections (secondary outcome) compared to propofol. Methods: This was a retrospective before–after trial (IRB EA1/143/20) performed at a tertiary medical center in Berlin, Germany, between 10/2012 and 01/2015. Patients undergoing cardiac surgery were investigated within two observation intervals, during which etomidate and propofol were the sole induction agents. Results: One-thousand, four-hundred, and sixty-two patients, and 622 matched pairs, after caliper propensity-score matching, were included in the final analysis. Sepsis rates did not differ in the matched cohort (etomidate: 11.5% vs. propofol: 8.2%, p = 0.052). Patients in the etomidate interval were more likely to develop hospital-acquired pneumonia (etomidate: 18.6% vs. propofol: 14.0%, p = 0.031). Conclusion: Our study showed that a single-dose of etomidate is not statistically associated with higher postoperative sepsis rates after cardiac surgery, but is associated with a higher incidence of hospital-acquired pneumonia. However, there is a notable trend towards a higher sepsis rate. |
format | Online Article Text |
id | pubmed-8269440 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-82694402021-07-10 Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery—Results of a Retrospective, before–after Study Weiss, Björn Schiefenhövel, Fridtjof Grunow, Julius J. Krüger, Michael Spies, Claudia D. Menk, Mario Kruppa, Jochen Grubitzsch, Herko Sander, Michael Treskatsch, Sascha Balzer, Felix J Clin Med Article Background: Etomidate is typically used as an induction agent in cardiac surgery because it has little impact on hemodynamics. It is a known suppressor of adrenocortical function and may increase the risk for post-operative infections, sepsis, and mortality. The aim of this study was to evaluate whether etomidate increases the risk of postoperative sepsis (primary outcome) and infections (secondary outcome) compared to propofol. Methods: This was a retrospective before–after trial (IRB EA1/143/20) performed at a tertiary medical center in Berlin, Germany, between 10/2012 and 01/2015. Patients undergoing cardiac surgery were investigated within two observation intervals, during which etomidate and propofol were the sole induction agents. Results: One-thousand, four-hundred, and sixty-two patients, and 622 matched pairs, after caliper propensity-score matching, were included in the final analysis. Sepsis rates did not differ in the matched cohort (etomidate: 11.5% vs. propofol: 8.2%, p = 0.052). Patients in the etomidate interval were more likely to develop hospital-acquired pneumonia (etomidate: 18.6% vs. propofol: 14.0%, p = 0.031). Conclusion: Our study showed that a single-dose of etomidate is not statistically associated with higher postoperative sepsis rates after cardiac surgery, but is associated with a higher incidence of hospital-acquired pneumonia. However, there is a notable trend towards a higher sepsis rate. MDPI 2021-06-29 /pmc/articles/PMC8269440/ /pubmed/34209919 http://dx.doi.org/10.3390/jcm10132908 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Weiss, Björn Schiefenhövel, Fridtjof Grunow, Julius J. Krüger, Michael Spies, Claudia D. Menk, Mario Kruppa, Jochen Grubitzsch, Herko Sander, Michael Treskatsch, Sascha Balzer, Felix Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery—Results of a Retrospective, before–after Study |
title | Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery—Results of a Retrospective, before–after Study |
title_full | Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery—Results of a Retrospective, before–after Study |
title_fullStr | Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery—Results of a Retrospective, before–after Study |
title_full_unstemmed | Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery—Results of a Retrospective, before–after Study |
title_short | Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery—Results of a Retrospective, before–after Study |
title_sort | infectious complications after etomidate vs. propofol for induction of general anesthesia in cardiac surgery—results of a retrospective, before–after study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269440/ https://www.ncbi.nlm.nih.gov/pubmed/34209919 http://dx.doi.org/10.3390/jcm10132908 |
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