Patients on Ventilator Healed By Steroid Treatment
by admin ~ May 28th, 2009.
Studies have showed that adrenal insufficient patients can be weaned off rapidly out of ICU if they go for a hydrocortisone infusion before extubation.
Researchers studied 93 critically ill patients, 91.4% of the 70 with relative adrenal insufficiency who received hydrocortisone infusions were successfully weaned from a ventilator, compared with 68.8% of those who received a saline placebo.
Corticosteroids, generally known as stress doses, when given to a patient on ventilator, can lead to a significantly higher success rate for ventilator weaning. It was revealed that there tend to be subnormal corticosteroid production during critical illness, particularly septic shock, in the absence of structural defects in the hypothalamic-pituitary-adrenal axis and this state is called “Functional adrenal insufficiency.”
From med page today:
ICU patients with adrenal insufficiency stand a better chance of being weaned off a ventilator more rapidly if they are treated with hydrocortisone before extubation is attempted.
“In this study, stress dose corticosteroid supplementation before extubation of patients with adrenal insufficiency led to a significantly higher success rate for ventilator weaning and a shorter weaning duration than in the placebo group,” they wrote.
“The successful ventilator weaning percentage was significantly higher (p = 0.035) in the adequate adrenal reserve group (88.4%) and in the stress dose hydrocortisone treatment group (91.4%) than in the placebo group (68.6%),” the authors wrote.
The study showed that 32 out of 35 patients administered with hydrocortisone were successfully taken off ventilators, compared with 24 of 35 in the control group. Among the 20 patients with adequate adrenal reserves, 20 of 20 patients were taken off ventilator, but three failed after extubation, as reported by the clinical trial studies. These patients were administered with 50 mg intravenous hydrocortisone, every six hours during the weaning period and were on regular corticosteroids before or during the admission.
Results showed that weaning period was shorter for patients who had received hydrocortisone treatment on ventilator in the group than in the placebo group.
Category: Anabolic Steroids | Tags: corticosteroid, extubation, hydrocortisone, hypothalamic-pituitary-adrenal axis, ventilator