Early hydrocortisone for multiple trauma patients may lower the incidence of nosocomial pneumonia

Background Early post-traumatic pneumonia increases the duration of mechanical ventilation (MV), hospitalization, and risk of death. In this study, the efficacy of hydrocortisone therapy in the prevention of nosocomial pneumonia in multiple trauma patients has been assessed. Patients and methods Six...

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Bibliographic Details
Published in:Research and Opinion in Anesthesia & Intensive Care 2018-04, Vol.5 (2), p.115
Main Authors: Megahed, Mohamed, Habib, Tamer, Ahmed, Islam, Hefnawy, Mostafa
Format: Article
Language:English
Subjects:
Adrenal glands
Care and treatment
Clinical medicine
Critical care
Death
Drug dosages
Glucocorticoids
Hormones
Hydrocortisone
Illnesses
Infectious diseases
Islam
Medical research
Medicine
Methicillin
Pharmacy
Pneumonia
Sepsis
Steroids
Trauma
Traumatic brain injury
Ventilators
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Summary:Background Early post-traumatic pneumonia increases the duration of mechanical ventilation (MV), hospitalization, and risk of death. In this study, the efficacy of hydrocortisone therapy in the prevention of nosocomial pneumonia in multiple trauma patients has been assessed. Patients and methods Six hundred patients who were admitted with multiple trauma were randomly assigned into two groups. The early hydrocortisone (EH) group consisted of 300 patients who received intravenous hydrocortisone 200 mg/day within 24 h from admission or trauma for 5 days and 100 mg, 50 mg on the following 2 days, respectively. The no early hydrocortisone group consisted of 300 patients who received placebo. All patients were followed up for the incidence of noscomial pneumonia. The days of ICU stay, MV, and mortality rates were calculated in both groups as secondary outcomes. Results The incidence of nosocomial pneumonia in the EH group was significantly lower than the no early hydrocortisone group [120 (40%) vs. 240 (80%), P< 0.0001].The EH group showed shorter durations of ICU stay (9.89 vs. 13.6 days, P=0.0027) and MV (7.98+-2.31 vs. 10.98+-3.98, P=0.0031), respectively. Conclusion The use of early intravenous stress dose of hydrocortisone in patients with multiple trauma may be associated with lower incidence of nosocomial pneumonia but with no difference in mortality.
ISSN:2356-9115
2356-9123
DOI:10.4103/roaic.roaic_59_17