Alinejad Faranak, Momeni Mahnoush, Fatemi Mohammad Javad, Saberi Mohsen, Sattarzade Mahboobeh, Babajani Rafat, Rahbar Hossein
Burn Research Center, Iran University Of Medical Sciences, Tehran, Iran.
Department of Community Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Iran J Microbiol. 2015 Dec;7(6):315-8.
Hydrocortisone is widely used in septic shock cases resistant to fluid and vasopressor therapy. It may result in increased blood pressure and survival. However the efficacy is no established among patients with severe burn and septic shock. Accordingly it was assessed in this study.
The patients older than 14 years of age with resistant septic shock were enrolled during one-year period. The hydrocortisone was prescribed 100 mg three times per day and the alterations in systolic and diastolic blood pressures were recorded.
Twenty-nine patients were enrolled including 19 men and 10 women. The mean age was 37 ± 19 years and the mean burn surface area was 60 ± 20. Fourteen patients had positive blood culture. The most common isolated microorganism were Pseudomonas aeuroginosa in 34.6%(10 cases), and then Acinetobacter in 13.8%(4 cases). The infection was from wound in 79% and the remaining 21% had pneumonia. Twenty-one patients had good response to hydrocortisone and the increase in systolic and diastolic blood pressures was significant; but the mortality rate was similar.
Treatment with hydrocortisone would result in increase in systolic and diastolic blood pressure in burn patients with resistant septic shock.
氢化可的松广泛应用于对液体和血管加压药物治疗无效的感染性休克病例。它可能会使血压升高并提高生存率。然而，其在严重烧伤合并感染性休克患者中的疗效尚未确定。因此，本研究对其进行了评估。
在一年期间纳入年龄大于14岁的难治性感染性休克患者。给予氢化可的松100mg，每日3次，并记录收缩压和舒张压的变化。
共纳入29例患者，其中男性19例，女性10例。平均年龄为37±19岁，平均烧伤面积为60±20。14例患者血培养阳性。最常见的分离微生物是铜绿假单胞菌，占34.6%（10例），其次是不动杆菌，占13.8%（4例）。79%的感染来自伤口，其余21%为肺炎。21例患者对氢化可的松反应良好，收缩压和舒张压显著升高；但死亡率相似。
对于难治性感染性休克的烧伤患者，使用氢化可的松治疗可导致收缩压和舒张压升高。
