Effect of Etomidate on Hemodynamics and Adrenocortical Function After Cardiac Surgery

Effect of an Anesthetic Induction Dose of Etomidate on Hemodynamics and Adrenocortical Function After Cardiac Surgery

The purpose of this study is to evaluate the effect of a single dose of etomidate for patients undergoing cardiac surgery with the use of cardiopulmonary bypass (CPB) on post-CPB adrenocortical responsiveness, on requirements of hemodynamic support, and on use of intensive care resources.

Inclusion Criteria:

• Male or female patients undergoing elective

  • coronary artery bypass graft (primary or re-operation)
  • mitral valve reconstruction/replacement for mitral valve regurgitation

• Age between 18 and 80 years (extremes included)

• Subject itself has signed the informed consent

• No clinically relevant deviation from the laboratory's reference range of biochemistry, hematology, or urinalysis testing

Exclusion Criteria:

• Participation in another ongoing interventional trial
• Known adrenocortical insufficiency
• Use of etomidate or propofol within 1 week preoperatively
• Use of glucocorticoids within 6 month preoperatively
• Known sensitivity to etomidate, propofol, or emulgator
• Severe hepatic dysfunction (bilirubin > 3mg/dl)
• Severe renal dysfunction (plasma creatinine > 180mikromol/l)
• Sepsis, endocarditis or other chronic inflammatory disease
• Manifest insulin-dependent diabetes mellitus
• Positive HIV serology
• Hemodynamically significant carotid stenosis requiring treatment
• Serious illnesses: endocrine, neurological, psychiatric, metabolic disturbances
• Pregnancy or breast-feeding female; females will be subject to pregnancy testing
• Requirement of rapid sequence induction
• Emergency surgery
• History of asthma