Spinal Cord Injury
Corticosteroids Use Risk
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February 21st, 2006
"Risks Associated With Steroid Use in Intensive Care"
New studies have found that use of corticosteroids in intensive care patients can increase the risk of infection and death.
In a case controlled study, researchers found that patients in ICU who were given corticosteroid drugs to treat a variety of injuries received more harm than good. Several adverse effects were reported with the use of corticosteroids including pneumonia, bloodstream infections, urinary tract infections, other infections, increased length of stay in ICU, prolonged ventilator use, and death.
The study found that patients who received corticosteroids were three times as likely to develop pneumonia or a bloodstream infection . Risks of other infections including urinary tract infection and death rates also increased. In addition, patients on corticosteroids were hooked to a ventilator an average of five days longer and stayed in the ICU an average of seven days longer.
“If one considers the indications for the use of steroids in the ICU, the benefits may not outweigh the risks,” wrote Michael F. Rotondo, M.D. and Paul J. Schenarts, M.D. in a recent issue of the Archives of Surgery.
Corticosteroids are drugs commonly used in the ICU to reduce inflammation, especially in the brain and spinal column, and are given to patients with spinal cord injuries, relative adrenal insufficiency, or sepsis, a serious illness caused from bacterial infection. Prednisone, cortisone, dexamethasone, hydrocortisone, and triamcinolone are some of the most commonly administered systemic corticosteroids.
It remains controversial whether or not corticosteroids aid in the treatment of sepsis or relative adrenal insufficiency. However, studies have de-emphasized the use of steroids for the treatment of spinal cord injury patients.
“Caution must be taken to carefully consider the indications, risks, and benefits of corticosteroids when deciding on their use [in the ICU],” researchers concluded.
To learn more about the risks associated with corticosteroid use during ICU treatment, you may wish to speak with your health care professional.
