Relationship of Steroid Dosing and Duration of Mechanical Ventilation in Adult Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease.

BACKGROUND

The optimal steroid dose for patients who require mechanical ventilation (MV) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is unknown.

OBJECTIVE

The primary objective of the study is to describe the relationship between steroid doses prescribed and duration of MV.

METHODS

This was a retrospective study of patients admitted between October 2013 and September 2014 who were prescribed steroids and received MV for ≥48 hours for AECOPD.

RESULTS

Fifty-four patients were included in the study. Median maintenance daily dose of 300 mg/d (IQR: 150-300) prednisone equivalent was prescribed upon initiation of MV. The maintenance daily dose prescribed upon initiation of MV was visually plotted and was categorized into 2 groups: high dose (≥300 mg; n = 28) and low dose (<300 mg; n = 26). There was no relationship observed between the maintenance dose prescribed and duration of MV ( P = .44) or intensive care unit (ICU) length of stay (LOS; P = .63). Seventeen (31.5%) patients developed an infection during their hospital stay. These patients received a higher cumulative dose of steroids compared to those without an infection ( P = .035).

CONCLUSION

No relationship was observed between maintenance steroid dose prescribed and the duration of MV or ICU LOS. Evaluation of a safe and effective dose and duration of steroids in this population is warranted.