PACULit Daily Literature Update: Evaluation of Etomidate Use and Association with Mortality Compared with Ketamine among Critically Ill Patients Quiz

A 65-year-old male with a history of hypertension and chronic obstructive pulmonary disease (COPD) is admitted to the ICU with severe pneumonia requiring invasive mechanical ventilation (IMV). He has no known drug allergies and is currently on amlodipine 5 mg daily and tiotropium inhaler. The ICU team plans rapid sequence intubation (RSI) for airway management. The pharmacist is consulted to recommend an induction agent.

Based on recent evidence comparing etomidate and ketamine for induction in critically ill patients requiring IMV, which induction agent should the pharmacist recommend to potentially reduce hospital mortality?

A 72-year-old female with septic shock secondary to urinary tract infection is admitted to the ICU and requires invasive mechanical ventilation. She is intubated using etomidate for induction. Post-intubation, the ICU team considers corticosteroid therapy to manage septic shock and potential adrenal insufficiency.

What does current evidence suggest about the effect of corticosteroid administration after etomidate use on hospital mortality in critically ill patients?

A 58-year-old male trauma patient with no significant past medical history is admitted to the ICU after a motor vehicle accident. He requires rapid sequence intubation. The ICU pharmacist is asked to provide guidance on induction agent selection considering recent literature and patient-specific factors.

Considering the current evidence and patient population, what should the pharmacist recommend regarding the choice between etomidate and ketamine for induction?