Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Global utilization of low-dose corticosteroids in severe sepsis and septic shock: a report from the PROGRESS registry. | Beale et al. Critical Care 2010 14 R102 http content 14 3 R102 c CRITICAL CARE RESEARCH Open Access Global utilization of low-dose corticosteroids in severe sepsis and septic shock a report from the PROGRESS registry Richard Beale 1 2 Jonathan M Janes3 Frank M Brunkhorst4 Geoffrey Dobb5 Mitchell M Levy6 Greg S Martin7 Graham Ramsay8 Eliezer Silva9 Charles L Sprung10 Benoit Vallet11 Jean-Louis Vincent12 Timothy M Costigan3 Amy G Leishman3 Mark D Williams3 and Konrad Reinhart4 Abstract Introduction The benefits and use of low-dose corticosteroids LDCs in severe sepsis and septic shock remain controversial. Surviving sepsis campaign guidelines suggest LDC use for septic shock patients poorly responsive to fluid resuscitation and vasopressor therapy. Their use is suspected to be wide-spread but paucity of data regarding global practice exists. The purpose of this study was to compare baseline characteristics and clinical outcomes of patients treated or not treated with LDC from the international PROGRESS PROmoting Global Research Excellence in Severe Sepsis cohort study of severe sepsis. Methods Patients enrolled in the PROGRESS registry were evaluated for use of vasopressor and LDC equivalent or lesser potency to hydrocortisone 50 mg six-hourly plus 50 pg 9-alpha-fludrocortisone for treatment of severe sepsis at any time in intensive care units ICUs . Baseline characteristics and hospital mortality were analyzed and logistic regression techniques used to develop propensity score and outcome models adjusted for baseline imbalances between groups. Results A total of 8 968 patients with severe sepsis and sufficient data for analysis were studied. A total of 7 160 8 968 of patients received vasopressors and 3 051 8 968 of patients received LDC. Regional use of LDC was highest in Europe and lowest in Asia . Country use was highest in Brazil and lowest in Malaysia . A total of of patients on LDC were not receiving any .
