To the Editor: Dr Annane and colleagues1 excluded patients who received etomidate before
intubation because this agent could interfere with cortisol response to corticotropin.
However, the authors do not provide the number of patients excluded on this
basis. Furthermore, this exclusion criterion was not implemented until halfway
through the data collection phase. It would be of interest to know how many
included in this study received etomidate prior to that. It also would be
of interest to know the effect of removing these patients from the data analysis.
This would help answer the question of whether patients with septic shock
who have received etomidate should be routinely treated with exogenous corticosteroids.
Schenarts CL, March JA. Corticosteroids for Patients With Septic Shock. JAMA. 2003;289(1):41-44. doi:10.1001/jama.289.1.41-a