Etomidate is preferred for rapid sequence induction in a haemodynamically unstable trauma patient. The primary concern with its use in the ICU setting is:
- A Emergence delirium
- B Hepatotoxicity
- C Adrenocortical suppression ✓
- D Malignant hyperthermia
Correct answer: C. Adrenocortical suppression
Explanation
Etomidate inhibits 11-beta-hydroxylase, the adrenal enzyme required for the final step of cortisol synthesis, causing adrenocortical suppression that lasts 6–8 hours after a single induction dose and longer with infusions. This can be clinically significant in septic shock patients who depend on a stress cortisol response for haemodynamic stability. Emergence delirium is a feature of ketamine, not etomidate.
Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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