The Role of Etomidate for Rapid Sequence Intubation in Emergency Medicine: A Systematic Review

Seyed Pouya  Paknezhad; Kavous  Shahsavarinia; Morteza  Ghojazadeh; Fatemeh Jangjou  Esfahlan; Maryam  Soleimanpour; Sarvin  Sanaie; Hassan  Soleimanpour

doi:10.18502/aacc.v11i1.17497

Seyed Pouya Paknezhad Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran.
Kavous Shahsavarinia Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Morteza Ghojazadeh Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Fatemeh Jangjou Esfahlan Student Research Committee, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Maryam Soleimanpour Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Sarvin Sanaie Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Hassan Soleimanpour Medical Philosophy and History Research Center. Tabriz University of Medical Sciences, Tabriz, Iran.

DOI: https://doi.org/10.18502/aacc.v11i1.17497

Keywords: Etomidate; Rapid sequence intubation; Emergency medicine

Abstract

Background: Etomidate, a short-acting hypnotic drug, plays a pivotal role in induction for intubation, particularly in emergency settings. Its favourable hemodynamic profile renders it a suitable choice for patients with hemodynamic instability

Methods: In this systematic review, we aim to delineate its role in emergency ward settings. Through a systematic search across databases, we identified nine eligible studies for inclusion. We searched the databases of PubMed, Scopus, ProQuest, and Medline (Ovid) from 2004 to 2023 for Randomized Controlled Trials (RCTs) and observational studies in which the study population was referred to the emergency department and received etomidate for Rapid sequence intubation (RSI).

Results: These studies collectively underscored the safety and efficacy of etomidate in emergency patients, with its suppressive effects on the adrenal axis deemed clinically insignificant.

Conclusion: The rapid onset of action and favourable hemodynamic profile position etomidate as a desirable agent for rapid sequence induction. However, further studies are warranted to strengthen recommendations in this regard.