Document Detail


Beneficial effect of corticosteroids in catecholamine-dependent septic burn patients.
MedLine Citation:
PMID:  17382191     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent studies indicated the benefit of hydrocortisone in septic patients based on the significant reduction of catecholamines and improved outcome in common intensive care patients. The treatment of intensive care burn patients with corticosteroids was discussed with great caution due to the especially compromised immune status of severely burned patients. The purpose of this study was to investigate the influence of corticosteroids in burn patients during septic shock. In our burn unit, we started with the administration of cortisol in 2001. In this retrospective study, 10 severely burned patients received, > or = 24h after norepinephrine dependency, hydrocortisone infusions of 200 mg/24 h. The course of norepinephrine dose, hemodynamic measurements (Swan-Ganz-Catheter) and daily Sequential Organ Failure Assessment (SOFA-Score) were analyzed and compared to nine (catecholamine-dependent) burn patients without cortisol therapy. Statistical analysis by means of Fisher's Exact Test revealed beneficial effects (morbidity and mortality) of low dose cortisol therapy compared to control patients. However, the results of this study must be interpreted with caution because of its limited number of patients and its retrospective character. Further randomized prospective controlled studies are necessary to determine the efficacy and safety of cortisol therapy in burn patients.
Authors:
P Ch Fuchs; A Bozkurt; D Johnen; R Smeets; A Groger; N Pallua
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  33     ISSN:  0305-4179     ISO Abbreviation:  Burns     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-07-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  England    
Other Details:
Languages:  eng     Pagination:  306-11     Citation Subset:  IM    
Affiliation:
Department of Plastic, Reconstructive, and Hand Surgery, Burn Center, University Hospital RWTH, Aachen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anti-Inflammatory Agents / administration & dosage*
Burns / drug therapy*,  metabolism
Case-Control Studies
Female
Humans
Hydrocortisone / administration & dosage*
Infusions, Intravenous
Lung Diseases / etiology
Male
Middle Aged
Norepinephrine / therapeutic use*
Retrospective Studies
Shock, Septic / drug therapy*,  etiology,  metabolism
Steroid 11-beta-Hydroxylase / antagonists & inhibitors
Urinary Tract Infections / etiology
Vasoconstrictor Agents / therapeutic use*
Wound Infection / etiology
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Vasoconstrictor Agents; 50-23-7/Hydrocortisone; 51-41-2/Norepinephrine; EC 1.14.15.4/Steroid 11-beta-Hydroxylase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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