ECMO-/ECLS

o May cause hiccups, nausea, vomiting on emergence.
Myoclonus and uncontrolled eye movements also
reported.
 Dosing: 0.2 – 0.3 mg/kg bolus over 30-60 seconds.
o Maintenance: 10-20 mcg/kg/min
o Procedural sedation: 0.1-0.3 mg/kg
 Onset & elimination:onset 30-60 seconds. Maximum effect 1
minute.
o Dose dependent duration of action 2-10 minutes
o Rapid redistribution resulting in rapid recovery
o Elimination half-life 2 -3 hours; prolonged in patients
with renal failure or hepatic failure.
 Precautions:
o Single dose of etomidate blocks normal stress induced
increase in cortisol production by inhibiting 11-B –
hydroxlase, which is necessary for the production of
cortisol.
 Avoid in patients in septic shock due to the
adverse consequences of adrenal suppression
o Prolonged infusions not recommended due to risk of
propylene glycol toxicity.
o Use with caution in patients with seizure disorders.
May cause EEG burst suppression at high doses.