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Another large database evaluation of the use of etomidate vs. ketamine as an induction agent for intubation found a trend toward higher mortality in the etomidate group. Even when trying to control for steroid use (to control for etomidate’s possible adrenal suppression), etomidate had a higher mortality rate.
A well done study that adds to the chorus advocating for choosing ketamine when looking for a hemodynamically neutral induction agent.
References
Wunsch H, Bosch NA, Law AC, Vail EA, Hua M, Shen BH, Lindenauer PK, Juurlink DN, Walkey AJ, Gershengorn HB. Evaluation of Etomidate Use and Association with Mortality Compared with Ketamine among Critically Ill Patients. Am J Respir Crit Care Med. 2024 Nov 15;210(10):1243-1251. doi: 10.1164/rccm.202404-0813OC. PMID: 39173173.