SciELO - Scientific Electronic Library Online

 
vol.124 issue2Maternal outcome in HELLP syndrome requiring intensive care management in a Turkish hospitalMicrovessel density in the placental bed among preeclampsia patients author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

Share


Sao Paulo Medical Journal

Print version ISSN 1516-3180On-line version ISSN 1806-9460

Abstract

CICARELLI, Domingos Dias; BENSENOR, Fábio Ely Martins  and  VIEIRA, Joaquim Edson. Effects of single dose of dexamethasone on patients with systemic inflammatory response. Sao Paulo Med. J. [online]. 2006, vol.124, n.2, pp.90-95. ISSN 1516-3180.  http://dx.doi.org/10.1590/S1516-31802006000200008.

CONTEXT AND OBJECTIVE: Systemic inflammatory response syndrome (SIRS) is a very common condition among critically ill patients. SIRS, sepsis, septic shock and multiple organ dysfunction syndrome (MODS) can lead to death. Our aim was to investigate the efficacy of a single dose of dexamethasone for blocking the progression of systemic inflammatory response syndrome. DESIGN AND SETTING: Prospective, randomized, double-blind, single-center study in a postoperative intensive care unit (Surgical Support Unit) at Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. METHODS: The study involved 29 patients with SIRS. All eligible patients were prospectively randomized to receive either a single dose of 0.2 mg/kg of dexamethasone or placebo, after SIRS was diagnosed. The patients were monitored over a seven-day period using Sequential Organ Failure Assessment score (SOFA). RESULTS: The respiratory system showed an improvement on the first day after dexamethasone was administered, demonstrated by the improved PaO2/FiO2 ratio (p < 0.05). The cardiovascular system of patients requiring vasopressor therapy also improved over the first two days, with a better evolution in the dexamethasone group (p < 0.05). Non-surviving patients presented higher lactate assays than did survivors (p < 0.05) during this period. CONCLUSIONS: Dexamethasone enhanced the effects of vasopressor drugs and evaluation of the respiratory system showed improvements (better PaO2/FiO2 ratio), one day after its administration. Despite these improvements, the single dose of dexamethasone did not block the evolution of SIRS.

Keywords : Sepsis syndrome; Sepsis; Inflammation; Adrenal cortex hormones; Dexamethasone.

        · abstract in Portuguese     · text in English     · English ( pdf epdf )

 

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License