Patients who were admitted to an intensive care unit with multiple traumas and received low doses of hydrocortisone for seven days had a 15 percent lower risk of developing hospital-acquired pneumonia compared with those that received a placebo, according to a new French study appearing in the Journal of the American Medical Association.
Severe trauma trauma patients usually are susceptible to catching pneumonia since their immune systems are compromised after the traumatic events. Between 40 to 60 percent of these patients--many of whom are brain injury patients--often develop hospital-acquired pneumonia. This can increase the risk of death while the patients are hospitalized, according to the researchers.
The use of the hydrocortisone also was associated with a decrease in the number of days that patients needed mechanical ventilation, compared with those who were given a placebo, note the researchers. The average time patients remained in the ICU was 18 days for those who received hydrocortisone and 24 days for those who received a placebo.
However, no significant difference in mortality was noted between the patients receiving the steroids and placebos in the randomized, blinded trial in which 149 patients participated.
While the study was well-designed, questions arise that need to be addressed in larger trials, said Eileen Bulger, MD, and Joseph Cuschieri, MD, both of the University of Washington in Seattle, in an accompanying editorial. Before changing clinical practice, a larger study is needed "to define the effects of steroid use on mortality," they said, as well as to gain "better understanding of the true incidence of corticosteroid insufficiency."
For more details:
- see the My Health News Daily story
- view the JAMA abstract