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Year : 2018  |  Volume : 5  |  Issue : 2  |  Page : 115-119

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

1 Department of Critical Care Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
2 Department of Clinical Pharmacy, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt

Correspondence Address:
Mohamed Megahed
21111, Department of Critical Care Medicine, Faculty of Medicine, Alexandria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/roaic.roaic_59_17

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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.

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