• diminution of 50% of the proportion of patients with a score SOFA of 3 or 4 [ Time Frame: 12h, 24h and 48h after the injection of hydrocortisone ] [ Designated as safety issue: No ]
  
• mean arterial blood pressure [ Time Frame: during the hospitalisation ] [ Designated as safety issue: Yes ]
  
• plasmatic cortisol and substance S before and after ACTH stimulation [ Time Frame: h-4; h6; h12 and h24 ] [ Designated as safety issue: No ]
  

• clinical state [ Time Frame: 12h and 24h ] [ Designated as safety issue: Yes ]
  
• hospitalisation duration in reanimation [ Time Frame: until day28 ] [ Designated as safety issue: No ]
  
• duration of mechanical ventilation [ Time Frame: until day28 ] [ Designated as safety issue: No ]
  
• duration and posology of adrenaline and noradrenaline [ Time Frame: h0, h4, h6, h12, h24 and h48 ] [ Designated as safety issue: No ]
  
• complications during hospitalization in reanimation potentially due to HSHC [ Time Frame: until day28 ] [ Designated as safety issue: Yes ]
  
• dose of etomidate injection [ Time Frame: h0 ] [ Designated as safety issue: No ]
  
• mortality [ Time Frame: day28 ] [ Designated as safety issue: Yes ]
  

Etomidate is a hypnotic widely used for patients in intensive care who require rapid induction, because of its short duration of action, its excellent cardiovascular tolerance and maintenance of cerebral perfusion pressure.

For this reason etomidate remains the hypnotic of choice for induction of unstable patients. Other hypnotics currently in existence do not provide adequate safety with a sufficiently predictable and stable effect in this situation. However, it may induce acute adrenal insufficiency by inhibition of 11-b-hydroxylase necessary for the synthesis of cortisol from compound S. An observational study conducted at the Grenoble University hospital in 2006 showed that the duration of this blockage can reach up to 48 hours. Acute adrenal insufficiency in intensive care patients is associated with a poor prognosis. The main objective of this study is to assess the value of substitution with 200mg/24h of hydrocortisone for 48 hours for patients in intensive care who have received a single injection of etomidate.

This is an interventional, prospective, randomized, placebo-controlled, double-blind, analytical study with a cohort of 100 patients between 18 and 80 years, of both sexes, who have had tracheal intubation in a pre-hospital or shock treatment setting with the administration of a single injection of etomidate.