Tuesday, 21 February 2006 00:00

Corticosteroids May Harm ICU Patients

TUESDAY, Feb. 21 (HealthDay News) -- Corticosteroid drugs may help lead to poorer outcomes, even death, for patients in the trauma intensive care unit (ICU), a new study finds.

Corticosteroid medications are used in ICUs to treat a number of conditions, including systemic blood infection (sepsis), spinal cord injury and swelling of the airway. While evidence suggests they are an effective treatment for sepsis, they also suppress the immune system and leave patients susceptible to infections and other complications, according to researchers at Eastern Virginia Medical School in Norfolk.

They published their findings in the February issue of the Archives of Surgery.

The study found that 100 patients in a trauma-burn ICU who received corticosteroids had more infections, longer stays in intensive care or longer periods on a ventilator, and a higher death rate than 100 ICU patients in a control group who did not receive corticosteroids.

The patients who received corticosteroids were more likely to develop pneumonia (26 percent vs. 12 percent), bloodstream infection (19 percent vs. 7 percent), or urinary tract infection (17 percent vs. 8 percent).

Patients in the corticosteroid group also stayed in the ICU longer (17.6 days vs. 10.2 days), were on a ventilator longer (9.9 days vs. 4.9 days), and were more likely to die than patients who did receive corticosteroids.

The researchers also noted that corticosteroid use may not have been appropriate for many of the patients in this study.

"Thirty-nine of the 100 patients in our study received corticosteroids for an indication supported by the literature," they wrote. "The remaining 61 should not have received corticosteroids based on strict interpretation of the current literature. Certainly the risk of infection outweighs the potential benefit in these cases."

"Caution must be taken to carefully consider the indications, the risks and benefits of corticosteroids when deciding on their use," the Virginia team concluded.

More information

The U.S. National Library of Medicine has more about corticosteroids.