Critical care medicine
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Critical care medicine · Nov 2012
Review Meta AnalysisEtomidate is associated with mortality and adrenal insufficiency in sepsis: a meta-analysis*.
To evaluate the effects of single-dose etomidate on the adrenal axis and mortality in patients with severe sepsis and septic shock. ⋯ Administration of etomidate for rapid sequence intubation is associated with higher rates of adrenal insufficiency and mortality in patients with sepsis.
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Critical care medicine · Nov 2012
Review Meta AnalysisEfficacy spectrum of antishivering medications: meta-analysis of randomized controlled trials.
Shivering after anesthesia or in the critical care setting is frequent, can be prolonged, and has the potential for serious adverse events and worsening outcomes. Furthermore, there are conflicting published data and clinical protocols on how to best treat shivering. In this study, we aimed to critically analyze the published evidence of antishivering medications. ⋯ There is significant heterogeneity in the literature with respect to study methods and efficacy testing of antishivering treatments. Clonidine, meperidine, tramadol, nefopam, and ketamine were the most frequently reported pharmacological interventions and showed a variable degree of efficacy in randomized, double-blinded, placebo-controlled trials.