, Volume 36, Issue 7, pp 1266-1267
Date: 20 Apr 2010

Is etomidate really that bad in septic patients?

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I congratulate Cuthbertson et al. [1] for their effort to enlighten the debate [210] on etomidate safety in critically ill patients. Nevertheless I cannot agree with some conclusions in their paper. I also would like to ask some questions to the authors, which I believe would help readers to understand some statements in their publication.

First, I would like to ask if this sub-study was previously registered elsewhere as an a priori topic to be analyzed. As far as I know, it was not mentioned in the original CORTICUS study as a primary or as a secondary end-point to be studied. From a practical point of view this is a post hoc analysis of data and not “an a priori sub-study of the CORTICUS study” as the authors declare.

The authors make some surprising conclusions that do not seem to agree with data gathered from the study.

Patients who received etomidate for more than 72 h before study enrollment were not excluded from the analysis. This implies that the authors believe that, if there

An author’s reply to this comment is available at: doi:10.1007/s00134-010-1872-y.