Single Dose of Etomidate and Adrenal Cortex

Study Overview
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Brief Summary
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we aim to evaluate the effects of single dose of etomidate or use of steroid prior to etomidate during emergency intubation on hemodynamics and adrenal cortex.

Official Title
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the Effect of Single Dose of Etomidate Used During Emergency Intubation on Hemodynamics and Adrenal Cortex: a Randomized Clinical Trial

Conditions
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Adrenocortical Deficiency, Hemodynamic Instability

Intervention / Treatment
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* Drug: Etomidate
* Drug: Midazolam
* Drug: methylprednisolone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients between 25-65 years old with American Society of Anesthesiology scores III or IV that have applied to emergency department and receives an indication for intubation by the intensive care unit physicians will be included to the study Exclusion Criteria: Patients using steroid prior to the intubation and/or patients with chronical inflammatory diseases will be excluded from the study.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Etomidate<br>After taking of the blood samples, patients in Group I will be intubated with 0.3 mg/kg etomidate iv. Blood samples will be repeated in the 4th and 24th hour of the intubation.systolic, diastolic and mean arterial pressures, heart rates will be recorded with 15 minutes intervals in the first hour and after that hourly during surgery.Cortisol Levels in the 0,4th and 24th hour will be compared from the blood samples acquired. | Drug: Etomidate<br> <br> * Other names: etomidate lipuro, BRAUN;|
| Active Comparator: etomidate, steroid<br>After taking of the blood samples, patients in Group II will be intubated with 0.3 mg/kg etomidate iv following a 2mg/kg methylprednisolone iv Blood samples will be repeated in the 4th and 24th hour of the intubation.systolic, diastolic and mean arterial pressures, heart rates will be recorded with 15 minutes intervals in the first hour and after that hourly during surgery.Cortisol Levels in the 0,4th and 24th hour will be compared from the blood samples acquired. | Drug: Etomidate<br> <br> * Other names: etomidate lipuro, BRAUN;Drug: methylprednisolone<br> <br> * Other names: Prednol-L, Mustafa Nevzat;|
| Active Comparator: midazolam<br>After taking of the blood samples, patients in Group III will be intubated with 0.01 mg/kg midazolam iv. Blood samples will be repeated in the 4th and 24th hour of the intubation.systolic, diastolic and mean arterial pressures, heart rates will be recorded with 15 minutes intervals in the first hour and after that hourly during surgery. Cortisol Levels in the 0,4th and 24th hour will be compared from the blood samples acquired. | Drug: Midazolam<br> <br> * Other names: Dormicum,Roche;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| effect of use of steroid on adrenal cortex prior to single dose etomidate by comparing cortisol levels |  | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| compare effects of midazolam and etomidate on systemic blood pressure |  | 24 hours |