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Steroid May Help Cut Pneumonia Risk After Brain Trauma
Date:3/22/2011

in their body, the breakdown of risk was similar: More than 54 percent of the placebo patients developed pneumonia, but the same was true for less than 36 percent of the hydrocortisone-treated patients.

Although the overall risk of death was comparable between the two groups, those in the steroid group had less need for mechanical ventilation assistance, less overall time in an ICU, and a lower risk of developing either acute lung injury or acute respiratory distress syndrome. In addition, none of the hydrocortisone patients developed a low concentration of blood sodium ("hyponatremia"), but more than 9 percent of the placebo group did, according to the study.

For his part, Dr. Lisandro Irizarry, chair of the emergency department and emergency training program at the Brooklyn Hospital Center in New York City, described the study as "interesting," and suggested that if it holds up upon further research it could become "part of the standardized care."

In fact, "it's already not uncommon for patients who have had major trauma such as brain injury to be given a level of steroids. Because anybody who sustains significant trauma may have compromised protective mechanisms for their airways, as a result of not having the normal capacity to engage in routine oral hygiene, routine coughing, routine expectorating of phlegm. This means a greater amount of bacteria can reach down and raise the risk for pneumonia," he noted.

"Now when a body undergoes a major stress, such as trauma, there are certain key hormones in the body that are called upon to assist in healing, such as hydrocortisone," Irizarry explained. "But in fact this process can be impaired by trauma. So the idea here is to give a patient an external supplement of steroid for a short period of time to augment their body's own healing response, because it gives the body a maximal stress hormone load-up at the beginning of the trauma healing. So this certainly makes sense," according to Irizarry
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