Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery-Results of a Retrospective, before-after Study.
Infectious Complications after Etomidate vs. Propofol for Induction of General Anesthesia in Cardiac Surgery-Results of a Retrospective, before-after Study.
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DOI：
10.3390/jcm10132908
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发表时间：
2021-06-29
影响因子：
3.9
通讯作者：
Balzer F
中科院分区：
文献类型：
--
作者：
Weiss B;Schiefenhövel F;Grunow JJ;Krüger M;Spies CD;Menk M;Kruppa J;Grubitzsch H;Sander M;Treskatsch S;Balzer F
背景：依托咪酯对血流动力学影响较小，常用作心脏手术的诱导剂。它是一种已知的肾上腺皮质功能抑制剂，可能增加术后感染、败血症和死亡率的风险。本研究的目的是评价与丙泊酚相比，依托咪酯是否会增加术后脓毒症（主要结局）和感染（次要结局）的风险。研究方法：这是一项回顾性前后试验（IRB EA 1/143/20），于2012年10月至2015年1月在德国柏林的一家三级医疗中心进行。接受心脏手术的患者在两个观察期内进行了研究，在此期间依托咪酯和丙泊酚是唯一的诱导剂。结果如下：在卡尺倾向评分匹配后，100462例患者和622对匹配配对被纳入最终分析。匹配队列中的脓毒症发生率无差异（依托咪酯：11.5% vs丙泊酚：8.2%，p = 0.052）。依托咪酯间隔期的患者更可能发生医院获得性肺炎（依托咪酯：18.6% vs.丙泊酚：14.0%，p = 0.031）。结论：我们的研究表明，单剂量依托咪酯与心脏手术后较高的术后脓毒症发生率无统计学相关性，但与较高的医院获得性肺炎发生率相关。然而，存在脓毒症发生率升高的显著趋势。
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.
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DOI：
10.1186/cc11871
发表时间：
2012-11-21
期刊：
Critical care (London, England)
影响因子：
--
作者：
Jung B;Clavieras N;Nougaret S;Molinari N;Roquilly A;Cisse M;Carr J;Chanques G;Asehnoune K;Jaber S
通讯作者：
Jaber S
DOI：
10.3205/000223
发表时间：
2015-01-01
期刊：
German medical science : GMS e-journal
影响因子：
--
作者：
Baron, Ralf;Binder, Andreas;Weisshaar, Guido
通讯作者：
Weisshaar, Guido
影响因子：
8.8
作者：
Wagner, Chad E.;Bick, Julian S.;Pretorius, Mias
通讯作者：
Pretorius, Mias
影响因子：
3.6
作者：
Basciani, Reto M.;Rindlisbacher, Antje;Eberle, Balthasar
通讯作者：
Eberle, Balthasar
DOI：
10.5455/medarh.2017.71.198-203
发表时间：
2017-06-01
期刊：
Medical archives (Sarajevo, Bosnia and Herzegovina)
影响因子：
--
作者：
Soleimani, Aria;Heidari, Neda;Sohrabi, Fatemeh Bozorg
通讯作者：
Sohrabi, Fatemeh Bozorg