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首页> 外文期刊>Sao Paulo Medical Journal >Early dexamethasone treatment for septic shock patients: a prospective randomized clinical trial
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Early dexamethasone treatment for septic shock patients: a prospective randomized clinical trial

机译：败血性休克患者早期地塞米松治疗：一项前瞻性随机临床试验

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CONTEXT AND OBJECTIVE: Sepsis and septic shock are very common conditions among critically ill patients that lead to multiple organ dysfunction syndrome (MODS) and death. Our purpose was to investigate the efficacy of early administration of dexamethasone for patients with septic shock, with the aim of halting the progression towards MODS and death. DESIGN AND SETTING: Prospective, randomized, double-blind, single-center study, developed in a surgical intensive care unit at Hospital das Clínicas, Faculdade de Medicina da Universidade de S?o Paulo. METHODS: The study involved 29 patients with septic shock. All eligible patients were prospectively randomized to receive either a dose of 0.2 mg/kg of dexamethasone (group D) or placebo (group P), given three times at intervals of 36 hours. The patients were monitored over a seven-day period by means of the sequential organ failure assessment score. RESULTS: Patients treated with dexamethasone did not require vasopressor therapy for as much time over the seven-day period as did the placebo group (p = 0.043). Seven-day mortality was 67% in group P (10 out of 15) and 21% in group D (3 out of 14) (relative risk = 0.31, 95% confidence interval 0.11 to 0.88). Dexamethasone enhanced the effects of vasopressor drugs. CONCLUSIONS: Early treatment with dexamethasone reduced the seven-day mortality among septic shock patients and showed a trend towards reduction of 28-day mortality.
机译：背景与目的：败血症和败血性休克是重症患者中很常见的疾病，可导致多器官功能障碍综合征（MODS）和死亡。我们的目的是研究早期给予地塞米松对败血性休克患者的疗效，以制止向MODS的发展和死亡。设计与地点：前瞻性，随机，双盲，单中心研究，在圣保罗大学医学院的克利斯尼卡斯医院外科重症监护室进行。方法：该研究涉及29名败血性休克患者。前瞻性将所有符合条件的患者随机分为接受剂量为0.2 mg / kg的地塞米松（D组）或安慰剂（P组），每36小时间隔3次。通过连续的器官衰竭评估评分对患者进行为期7天的监测。结果：地塞米松治疗的患者在7天的时间内不需要像安慰剂组那样接受升压药物治疗（p = 0.043）。 P组的7天死亡率为67％（15个中有10个），D组为21％（14个中有3个）（相对风险= 0.31，95％置信区间0.11至0.88）。地塞米松增强了血管加压药的作用。结论：地塞米松的早期治疗降低了败血性休克患者的7天死亡率，并显示出28天死亡率降低的趋势。

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