Patients who already presented a cardiovascular collapse after fluid loading or who were severely hypoxemic (SpO2 < 80%) after preoxygenation by noninvasive positive-pressure ventilation were not considered to have had an intubation-related complication, but rather to have presented a life-threatening selleck chemical condition requiring an emergency endotracheal intubation.During the ICU stay, we documented the results for basal plasma cortisol and that after the cosyntropin test, as well as total amounts and durations of hydrocortisone and vasopressor treatments from day 0 to day 5. Outcome data include the duration of shock, length of mechanical ventilation, nosocomial infection incidence, ICU and hospital lengths of stay, and day-28 mortality.Statistical analysisWe had sufficient resources to review 102 patients in total.

Descriptive data of quantitative variables were summarized as the mean �� standard deviation or median with interquartile range, according to the normality of the distribution, assessed with the Shapiro-Wilk test and compared with the Mann-Whitney or t test. Categorical data were expressed as the number and percentage and were compared with a chi-square analysis.Using two statistical methods, we assessed the occurrence of short-term life-threatening complications and the long-term outcomes according to the administration of etomidate versus another hypnotic drug. First, unadjusted differences between patients receiving etomidate or not were compared using logistic regression after calibration with the Hosmer-Lemeshow wellness-of-fit test.

Furthermore, long-term survival was assessed by a Cox regression in which we included all variables associated with P < 0.20 in the univariate analysis. A stepwise procedure then allowed the final multivariate model to be obtained.Second, since patients were not randomly assigned to etomidate or other hypnotic in this observational study, we developed a propensity score using all variables associated with P < 0.20 in the univariate analysis. The propensity score is defined as a subject's probability of receiving a specific treatment (for example, etomidate) conditional on the observed covariates, and thus controls for selection bias in observational studies [34]. For the coupling process, optimal one-to-one nearest neighbor matching was used. When needed, patients already matched were replaced by the closest one in the in the propensity score.

P < 0.05 was considered significant. Statistical analysis was performed by an independent statistician (NM), with R software (version 2.10.1).ResultsPopulation characteristicsDuring the study period, among 1,632 patients admitted to the ICU, 331 presented septic shock during their stay. Among these 331 patients, 229 either Brefeldin_A developed septic shock > 48 hours after intubation, did not have a cosyntropin test or data could not be extracted from the charts.