Figure 4.

Serum cortisol levels and etomidate doses in the three presented cases. (a) In Case 1, etomidate was introduced in a bolus of 2.5 mg, and the infusion velocity was gradually increased to reach 1 mg/h in the first 24 h and a maximum of 2.8 mg/h on day 8. The cortisol levels fell adequately. (b) In Case 2, the dosing regimen was similar to that in Case 1, with the infusion speed rates presented in the table. The target cortisol levels were reached in a week and, as the patient’s state improved, the infusion velocity was increased to achieve more physiological levels. (c) In Case 3, the presented fluctuating levels of cortisol were probably due to several complications during hospitalization and day-by-day alterations in the patients’ condition. Higher doses of etomidate (up to 5 mg/h) were necessary to control cortisol overproduction.