tailieunhanh - Báo cáo y học: "Effect of corticosteroids on the clinical course of community-acquired pneumonia: a randomized controlled trial"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Effect of corticosteroids on the clinical course of community-acquired pneumonia: a randomized controlled trial. | Fernandez-Serrano et al. Critical Care 2011 15 R96 http content 15 2 R96 KS CRITICAL CARE RESEARCH Open Access Effect of corticosteroids on the clinical course of community-acquired pneumonia a randomized controlled trial Cỉlt ỉ c S-. u- X. L . J 7 c S-. u- u- r-v 1 I r-v I Ch f V r 1 2 V r I I V r I ỉ 4 ỉ3 4 I I Z rl C 3 4 r ĩ c I fs r4 I mfn I A. 3 4 Silvia Fernandez-Serrano Jordi Dorca Carolina Garcia-Vidal Nuria Fernandez-Sabé Jordi Carratala 5 1 34 1 Ana Fernandez-Aguera Mercè Corominas Susana Padrones Francesc Gudiol Frederic Manresa Abstract Introduction The benefit of corticosteroids as adjunctive treatment in patients with severe community-acquired pneumonia CAP requiring hospital admission remains unclear. This study aimed to evaluate the impact of corticosteroid treatment on outcomes in patients with CAP. Methods This was a prospective double-blind and randomized study. All patients received treatment with ceftriaxone plus levofloxacin and methyl-prednisolone MPDN administered randomly and blindly as an initial bolus followed by a tapering regimen or placebo. Results Of the 56 patients included in the study 28 50 were treated with concomitant corticosteroids. Patients included in the MPDN group show a more favourable evolution of the pO2 FiO2 ratio and faster decrease of fever as well as greater radiological improvement at seven days. The time to resolution of morbidity was also significantly shorter in this group. Six patients met the criteria for mechanical ventilation MV five in the placebo group and one in the MPDN group . The duration of MV was 13 days interquartile range 7 to 26 days for the placebo group and three days for the only case in the MPDN group. The differences did not reach statistical significance. Interleukin IL -6 and C-reactive protein CRP showed a significantly quicker decrease after 24 h of treatment among patients treated with MPDN. No differences in mortality were found among groups. Conclusions .