tailieunhanh - Báo cáo y học: "Corticosteroids for sepsis: registry versus Cochrane systematic review"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Corticosteroids for sepsis: registry versus Cochrane systematic review! | Annane Critical Care 2010 14 185 http content 14 4 185 CRITICAL CARE COMMENTARY L__ Corticosteroids for sepsis registry versus Cochrane systematic review Djillali Annane See related research by Beale etal. http content 14 3 R102 Abstract A recent report from the PROGRESS registry highlighted that low dose corticosteroids are widely used in patients with sepsis around the world. In this report corticosteroids may be associated with increased morbidity and mortality. However these findings should be viewed with caution given that this study has several inherent flaws because of its retrospective nature and the lack of controlled use of corticosteroids. In this commentary these findings are contrasted with those of a recent Cochrane systematic review. A recent report from the PROGRESS registry warned readers of potential danger associated with the use of corticosteroids in patients with severe sepsis or septic shock 1 . In this retrospective analysis 3 051 out of 8 968 34 patients received treatment with low dose corticosteroids. Corticosteroid-treated patients were older had more co-morbidities and greater severity of illness than patients who did not receive corticosteroids. Subsequently there were more deaths among corticosteroid-treated patients even after controlling for various confounders. What is the current evidence on the benefit to risk ratio of corticosteroids in patients with septic shock A recent Cochrane systematic review of corticosteroid treatment for severe sepsis and septic shock found 17 randomized controlled trials n 2 138 and 3 quasi randomized trials n 246 2 . Computing data from the 17 randomized trials yielded a significant survival benefit from corticosteroids with a risk ratio RR of 95 confidence interval CI to P . There was Correspondence General Intensive Care Unit Raymond Poincaré Hospital AP-HP University of Versailles SQY 104 boulevard Raymond Poincaré .