The Pharmaceutical Journal
Vol 276 No 7390 p259
4 March 2006

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Problems with ICU corticosteroids identified

Corticosteroid use in intensive care is associated with increased rates of pneumonia and septicaemia, according to the authors of a case-control study (Archives of Surgery 2006;141:145).

Researchers looked at data for 100 patients who received corticosteroids during intensive care unit (ICU) stays and 100 matched ICU controls. Steroids are used in ICU for many indications, including spinal cord injury, septic shock, optic neuritis and airway oedema. Current ICU practice, the authors say, leans towards their use for patients with sepsis and relative adrenal insufficiency.

They found that corticosteroid use in ICU patients was associated with an increased rate of pneumonia (odds ratio 2.64, 95 per cent confidence interval 1.21–5.76; P<0.05) and septicaemia (OR 3.25, 95 per cent CI 1.26–8.38; P<0.05). Corticosteroid-treated patients spent five days longer on ventilators (P<0.01) and seven days longer in ICU (P<0.01). Trends towards urinary tract infection and increased mortality were observed.