Key result
Etomidate provided better hemodynamic stability before and after intubation compared to propofol, with a lower need for drugs to control hypotension (26% vs 62%, p=0.001) but a higher need for drugs to control the pressor response (38% vs 10%, p=0.002).
Why the study?
The hemodynamic responses of induction agents propofol and etomidate needed comparison in patients with LVEF ≤40% undergoing CABG surgery.
Does etomidate compared to propofol improve hemodynamic stability during anesthetic induction in patients with LVEF ≤40% undergoing elective CABG?
Population
100 patients with LVEF ≤40% scheduled for elective CABG
Comparison
Propofol 2mg/kg vs etomidate 0.2mg/kg
Design
Prospective, double-blinded, randomized, hospital based study
Authors
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Etomidate may be preferred for induction in LVEF ≤40% CABG to limit hypotension; extends RCT data on induction agents in systolic dysfunction.
RCT (n=100)
Double-blind
Computer generated random numbers
No
Does etomidate compared to propofol improve hemodynamic stability during anesthetic induction in patients with LVEF ≤40% undergoing elective CABG?
In patients with LVEF ≤40% undergoing CABG, etomidate provides better hemodynamic stability before and after intubation compared to propofol, though it is less effective at controlling the pressor response to intubation.
Carpenter et al. (2021) conducted an RCT in Left ventricular ejection fraction ≤ 40% undergoing elective coronary artery bypass grafting (CABG) (n=100). Etomidate vs. Propofol 2 mg/kg was evaluated on Hemodynamic effects in terms of heart rate, rhythm, mean blood pressure, and central venous pressure. Etomidate provided better hemodynamic stability before and after intubation compared to propofol, with a lower need for drugs to control hypotension (26% vs 62%, p=0.001) but a higher need for drugs to control the pressor response (38% vs 10%, p=0.002).
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