INFLUENCE OF VITAMIN C ON ETOMIDATE-INDUCED ADRENAL SUPPRESSION: A LITERATURE REVIEW

• DOI: https://doi.org/10.22533/at.ed.1594732405084

• Palavras-chave: Etomidate; Adrenal gland; Vitamin C

• Keywords: Etomidate; Adrenal gland; Vitamin C

• Abstract:

  Introduction: The use of etomidate has been limited due to its ability to induce adrenal suppression, and cortisol is known to play a fundamental role in maintaining hemodynamic stability. Vitamin C appears to promote the formation of cortisol in patients with etomidate-induced adrenal suppression, since it plays an important role in the synthesis of endogenous cortisol. Objectives: To summarize the outcomes of clinical trials conducted to date to evaluate the influence of vitamin C administration on etomidate-induced adrenal suppression. Methods: This is a descriptive bibliographical research based on a free literature review. The articles and texts used for analysis were published in the last 10 years in the PubMED, Cochrane Library, Embase and Scielo databases, using the Boolean operators “AND” and “OR”, and 13 works were selected. Results: Randomized clinical trials corroborate this finding, evaluating control groups (induced with etomidate) and intervention groups (induced with etomidate and administration of vitamin C), and finding statistically significant values (p<0.01) in serum cortisol levels. In addition, a recent meta-analysis associated the use of etomidate with mortality, and suggests that adrenal suppression is an important factor in this process. Conclusion: The administration of vitamin C appears safe and effective in maintaining serum cortisol levels, and it may be possible that it promotes a reduction in negative outcomes. However, some limitations, such as the low number of randomized clinical trials, make it difficult to consolidate the findings. The present study suggests that new clinical trials be conducted for elucidation purposes.