Whereas etomidate causes adrenal insufficiency, it was not shown to increase mortality in many analyzed here in ICU settings. However, etomidate associated relative mortality rates increased progressively and correlated with the severity of critical illness scores.

Intensivists should anticipate the need for glucocorticoid supplementation after etomidate in those with severe critical illness and in those with acute deterioration of vital signs.

There were 29 trials of etomidate versus comparators in 8,584 patients.

Etomidate was associated with adrenal insufficiency and increased overall relative mortality rates.

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