Steroids for Trauma Patients? The Jury Is Still Out.

Patients who experience severe trauma are at risk for developing hospital-acquired pneumonia. Stress-dose corticosteroids attenuate the overwhelming inflammatory response that leads to sepsis in critically ill patients, but their role in trauma patients is unclear.

Researchers performed a double-blind trial in 150 patients (age, >15 years) with multiple trauma (defined as ≥2 traumatic injuries and Injury Severity Score >15) in seven intensive care units (ICUs) in France. Patients were randomized to continuous intravenous infusions of either hydrocortisone (200 mg/day for 5 days; 100 mg on day 6; 50 mg on day 7) or placebo. Treatment was stopped if patients exhibited appropriate adrenal responses as measured by corticotropin testing at 2 days…