| High-dose corticosteroids in thoracic trauma. | |
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MedLine Citation:
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PMID: 3867204 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Experimental data show that lung injury may be prevented or reduced when steroids are administered early. It seems, however, difficult to reverse a lung injury which is already established. Accordingly, we have since 1976 administered high doses of methylprednisolone already on admission in patients with multiple rib fractures and/or flail chest (30 mg/kg i.v. X 3 at 8 hr intervals). A retrospective analysis of 143 patients with severe blunt chest trauma, most of whom were multitraumatized (72%) and many in shock (19%) revealed a significantly lower mortality for 44 steroid treated patients compared to 99 nonsteroid patients with similar injuries (9.1 vs 29.3%, p = 0.02). The incidence of bronchial infection and septicemia was not increased in steroid treated patients. There was also a lower incidence of multiple organ failure in the steroid treated group (4.5%) as compared to the control group (9.1%, n.s.). Hemodynamic and blood gas changes were examined in a prospective controlled study including 40 patients with multiple rib fractures and lung contusion. Pulmonary vascular resistance (PVR), which is a good parameter of injury severity, was reduced significantly in the steroid treated group. This led to a reduction in right heart work. The corticosteroid induced reduction in PVR was seen whether the patient was on a ventilator or breathed spontaneously. There were no significant differences in the a-v oxygen difference or in intrapulmonary shunting. Both the number of complications and the duration of artificial respiration were reduced in the steroid group. |
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Authors:
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J L Svennevig; B Bugge-Asperheim; O Geiran; J Vaage; J Pillgram-Larsen; N B Fjeld; S Birkeland |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta chirurgica Scandinavica. Supplementum Volume: 526 ISSN: 0301-1860 ISO Abbreviation: Acta Chir Scand Suppl Publication Date: 1985 |
Date Detail:
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Created Date: 1986-03-12 Completed Date: 1986-03-12 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0370305 Medline TA: Acta Chir Scand Suppl Country: SWEDEN |
Other Details:
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Languages: eng Pagination: 110-9 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Flail Chest / complications Hemodynamics / drug effects Humans Lung Injury Male Methylprednisolone / therapeutic use* Multiple Organ Failure Oxygen / blood Prospective Studies Pulmonary Artery / drug effects Retrospective Studies Rib Fractures / complications Shock, Traumatic / drug therapy*, etiology, prevention & control Thoracic Injuries / complications* Vascular Resistance / drug effects |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen; 83-43-2/Methylprednisolone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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