Hyperosmolar, increased-anion-gap metabolic acidosis and hyperglycemia after etomidate infusion

Hyperosmolar increased-anion-gap metabolic acidosis without hyperglycemia has been reported after infusions of etomidate and other medications containing propylene glycol. We report a case of this biochemical abnormality with severe hyperglycemia. Cessation of the etomidate infusion along with other supportive measures resulted in prompt resolution of the metabolic acidosis and hyperglycemia.