Featured Research

from universities, journals, and other organizations

Hydrocortisone therapy for trauma patients associated with reduced hospital-acquired pneumonia risk

Date:
March 22, 2011
Source:
JAMA and Archives Journals
Summary:
Patients admitted to a hospital with major trauma and treated with the steroid hydrocortisone were less likely to be diagnosed with hospital-acquired pneumonia than patients who received placebo, according to a new study.

Patients admitted to a hospital with major trauma and treated with the steroid hydrocortisone were less likely to be diagnosed with hospital-acquired pneumonia than patients who received placebo, according to a study in the March 23/30 issue of JAMA.

Related Articles


Severe trauma is one of the leading causes of death and illness in the world. "The overall rate of posttraumatic pneumonia reaches an incidence of 40 percent to 60 percent, mainly in patients with traumatic brain injury (TBI). Early posttraumatic pneumonia increases the duration of mechanical ventilation, hospitalization, and risk of death. Thus, prevention of posttrauma pneumonia is a major clinical and economical issue," according to background information in the article. "Both experimental and clinical data suggest that corticosteroid use may decrease the occurrence and severity of nosocomial [hospital-acquired] pneumonia in patients treated in intensive care units (ICUs)."

Antoine Roquilly, M.D., of the University of Nantes, France, and colleagues conducted the HYPOLYTE (Hydrocortisone Polytraumatise) study to examine whether treatment with stress-dose levels of hydrocortisone would reduce the prevalence of hospital-acquired pneumonia. The randomized trial, conducted from November 2006 to August 2009, included 150 patients with severe trauma from 7 ICUs in France. Patients were randomly assigned to a continuous intravenous infusion of either hydrocortisone (200 mg/d for 5 days, followed by 100 mg on day 6 and 50 mg on day 7) or placebo. The treatment was stopped if patients had an appropriate adrenal response.

Twenty-six of 73 patients (35.6 percent) treated with hydrocortisone and 39 of 76 patients (51.3 percent) treated with placebo developed hospital-acquired pneumonia at day 28 of hospitalization. Twenty of 56 patients with corticosteroid insufficiency (35.7 percent) who were treated with hydrocortisone and 31 of 57 patients (54.4 percent) receiving placebo developed hospital-acquired pneumonia at day 28.

The average duration of mechanical ventilation-free days was 16 days in the hydrocortisone group and 12 days in the placebo group. Three of 73 patients (4.1 percent) in the hydrocortisone group and 11 of 76 patients (14.5 percent) in the placebo group developed acute lung injury or acute respiratory distress syndrome (ARDS). The average length of ICU stay was 18 days in the hydrocortisone group and 24 days in the placebo group.

Seven of 76 patients (9.2 percent) in the placebo group and none of the 73 in the hydrocortisone group developed hyponatremia (low concentration of sodium in the blood). For the entire study population, 6 of 73 patients (8.2 percent) died in the hydrocortisone group and 4 of 76 (5.3 percent) died in the placebo group.

"In conclusion, a stress dose of hydrocortisone for 7 days is associated with a reduction in the rate of hospital-acquired pneumonia at day 28 together with a decreased requirement for mechanical ventilation and length of ICU stay in trauma patients. The effects and safety of corticosteroid therapy with stress-dose levels of hydrocortisone should be confirmed in trauma patients and investigated in other ICU populations, particularly in TBI patients," the authors write.

Editorial: Steroids After Severe Injury -- Many Unanswered Questions

In an accompanying editorial, Eileen M. Bulger, M.D., and Joseph Cuschieri, M.D., of the University of Washington, Seattle, comment on the findings of this study.

"In summary, the well-designed HYPOLYTE study suggests a potential benefit of early steroid administration for severely injured patients with corticosteroid insufficiency, but before changing clinical practice, a larger study is needed to define the effects of steroid use on mortality. In addition, a better understanding of the true incidence of corticosteroid insufficiency and the mechanism of manipulation of the immune-inflammatory response after injury would better guide this therapeutic approach."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. A. Roquilly, P. J. Mahe, P. Seguin, C. Guitton, H. Floch, A. C. Tellier, L. Merson, B. Renard, Y. Malledant, L. Flet, V. Sebille, C. Volteau, D. Masson, J. M. Nguyen, C. Lejus, K. Asehnoune. Hydrocortisone Therapy for Patients With Multiple Trauma: The Randomized Controlled HYPOLYTE Study. JAMA: The Journal of the American Medical Association, 2011; 305 (12): 1201 DOI: 10.1001/jama.2011.360
  2. E. M. Bulger, J. Cuschieri. Steroids After Severe Injury: Many Unanswered Questions. JAMA: The Journal of the American Medical Association, 2011; 305 (12): 1242 DOI: 10.1001/jama.2011.365

Cite This Page:

JAMA and Archives Journals. "Hydrocortisone therapy for trauma patients associated with reduced hospital-acquired pneumonia risk." ScienceDaily. ScienceDaily, 22 March 2011. <www.sciencedaily.com/releases/2011/03/110322161516.htm>.
JAMA and Archives Journals. (2011, March 22). Hydrocortisone therapy for trauma patients associated with reduced hospital-acquired pneumonia risk. ScienceDaily. Retrieved October 30, 2014 from www.sciencedaily.com/releases/2011/03/110322161516.htm
JAMA and Archives Journals. "Hydrocortisone therapy for trauma patients associated with reduced hospital-acquired pneumonia risk." ScienceDaily. www.sciencedaily.com/releases/2011/03/110322161516.htm (accessed October 30, 2014).

Share This



More Health & Medicine News

Thursday, October 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Reuters - Innovations Video Online (Oct. 29, 2014) A Swedish amputee who became the first person to ever receive a brain controlled prosthetic arm is able to manipulate and handle delicate objects with an unprecedented level of dexterity. The device is connected directly to his bone, nerves and muscles, giving him the ability to control it with his thoughts. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Google To Use Nanoparticles, Wearables To Detect Disease

Google To Use Nanoparticles, Wearables To Detect Disease

Newsy (Oct. 29, 2014) Google X wants to improve modern medicine with nanoparticles and a wearable device. It's all an attempt to tackle disease detection and prevention. Video provided by Newsy
Powered by NewsLook.com
Can Drinking Milk Lead To Early Death?

Can Drinking Milk Lead To Early Death?

Newsy (Oct. 29, 2014) Researchers in Sweden released a study showing heavy milk drinkers face an increased mortality risk from a variety of causes. Video provided by Newsy
Powered by NewsLook.com
Obama: The US Will Not 'run and Hide' From Ebola

Obama: The US Will Not 'run and Hide' From Ebola

AP (Oct. 29, 2014) Surrounded by health care workers in the White House East Room, President Barack Obama said the U.S. will likely see additional Ebola cases in the weeks ahead. But he said the nation can't seal itself off in the fight against the disease. (Oct. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins