机械通风
感染性休克
肺炎
败血症
社区获得性肺炎
安慰剂
医学
氢化可的松
沙发评分
休克(循环)
麻醉
呼吸衰竭
内科学
呼吸机相关性肺炎
外科
替代医学
病理
作者
Nirmeen A. Sabry,Emad Omar
出处
期刊:Pharmacology & Pharmacy
[Scientific Research Publishing, Inc.]
日期:2011-01-01
卷期号:02 (02): 73-81
被引量:89
标识
DOI:10.4236/pp.2011.22009
摘要
Background: Pneumonia is the most common cause of community-acquired infection requiring ICU admission.60% -87% of patients with severe community acquired pneumonia (CAP) admitted to the ICU develops respiratory failure and require mechanical ventilation (MV).Objectives: To assess the efficacy and safety of adjunctive low dose hydrocortisone infusion treatment in Egyptian ICU patients with CAP.Methods: Hospitalized patients, clinically and radiologically diagnosed with CAP, were randomized to receive hydrocortisone 12.5 mg/h IV infusion for 7 days or placebo, along with antibiotics.The end-points of the study were improvement in PaO 2 :FIO 2 (PaO 2 :FIO 2 > 300 or ≥ 100 increase from study entry) and SOFA score by study day 8 and the development of delayed septic shock.Results: 80 patients were recruited, 40 of them received hydrocortisone and the remaining 40 received placebo.By study day 8, hydrocortisone treated patients showed a significant improvement in PaO 2 :FIO 2 and chest radiograph score, and a significant reduction in C-reactive protein (CRP) levels, Sepsis-related Organ Failure Assessment (SOFA) score, and delayed septic shock compared to the control group.Hydrocortisone treatment was associated with a significant reduction in the duration of MV.However, hydrocortisone infusion did not show significant difference in the ICU mortality.Conclusions: adjunctive 7-day course of low dose hydrocortisone IV in patients with CAP hastens recovery of pneumonia and prevents the development of sepsis related complications with a significant reduction in duration of the mechanical ventilation.
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