Oliynyk Oleksandr V, Pereviznyk Bohdana O, Yemiashev Oleh V, Shlifirchyk Anna
Department of Anesthesiology, Ternopil State Medical University, Ternopil, Ukraine.
Pope John Paul II State School of Higher Education, Biała Podlaska, Poland.
Adv Clin Exp Med. 2016 Nov-Dec;25(6):1223-1226. doi: 10.17219/acem/61013.
Severe traumatic brain injury (STBI) is an important issue in contemporary medicine and treatment strategies are still in need of improvement. The most dangerous complications of STBI are multiple organ failure and severe sepsis. As many as 80% of STBI patients with multiple organ failure have acute respiratory distress syndrome (ARDS). The need for better treatment strategies for STBI has led to investigations of the positive therapeutic effects of corticosteroids (CS). About 10 to 15 years ago research showed the inexpediency of CS in STBI therapy, but there were also contradictory findings showing their effectiveness. STBI is frequently followed by severe sepsis, which is not usually treated with CS. No scientific papers investigated the usage or non-usage of CS in patients with STBI followed by severe sepsis and ARDS.
The aim of the study was to investigate the influence of CS usage on treatment results in patients with STBI followed by severe sepsis and ARDS.
The study involved an analysis of the treatment results in 267 patients with STBI followed by severe sepsis and ARDS, who were treated with and without CS.
The study showed that patients' mortality decreased 1.24 times with CS use (500 mg/day of Solu-Medrol® for three days, followed by dose reduction by one-half every 3 days). Patients who took CS survived longer than patients without this treatment. The duration mechanical ventilation was shorter in patients who were treated with CS compared to the other group.
Further research into CS use is needed to improve treatment strategies for STBI followed by severe sepsis and ARDS.
重型创伤性脑损伤（STBI）是当代医学中的一个重要问题，治疗策略仍有待改进。STBI最危险的并发症是多器官功能衰竭和严重脓毒症。多达80%发生多器官功能衰竭的STBI患者会出现急性呼吸窘迫综合征（ARDS）。对更好的STBI治疗策略的需求促使人们对皮质类固醇（CS）的积极治疗效果进行研究。大约在10到15年前的研究表明，CS用于STBI治疗并不适宜，但也有相互矛盾的研究结果显示其具有有效性。STBI常常继发严重脓毒症，而严重脓毒症通常不用CS治疗。尚无科学论文研究CS在继发严重脓毒症和ARDS的STBI患者中的使用情况或未使用情况。
本研究的目的是调查CS的使用对继发严重脓毒症和ARDS的STBI患者治疗结果的影响。
本研究分析了267例继发严重脓毒症和ARDS的STBI患者的治疗结果，这些患者接受了CS治疗和未接受CS治疗。
研究表明，使用CS（每天500毫克甲泼尼龙，持续三天，之后每三天剂量减半）可使患者死亡率降低1.24倍。接受CS治疗的患者比未接受该治疗的患者存活时间更长。与另一组相比，接受CS治疗的患者机械通气时间更短。
需要对CS的使用进行进一步研究，以改进继发严重脓毒症和ARDS的STBI的治疗策略。
