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Fabienne Venet Jonathan Plassais Julien Textoris Marie-Angélique Cazalis Alexandre Pachot Marc Bertin-Maghit Christophe Magnin Thomas Rimmelé Guillaume Monneret Sylvie Tissot 《Critical care (London, England)》2015,19(1)
IntroductionThe aim of this study was to assess the effect of low-dose corticosteroid therapy in reducing shock duration after severe burn.MethodsA placebo-controlled, double-blind, randomized clinical trial (RCT) was performed on two parallel groups in the burn intensive care unit (ICU). Patients were randomized to receive either low-dose corticosteroid therapy or placebo for seven days. A corticotropin test was performed at the time of randomization, before the administration of the treatment dose. Thirty-two severely burned patients with refractory shock (>0.5 μg/kg/min of norepinephrine) were prospectively included in the study.ResultsWe included 12 patients in the hydrocortisone-treated group and 15 patients in the placebo group in the final analysis. Among these patients, 21 were nonresponders to the corticotropin test. Median norepinephrine treatment duration (primary objective) was significantly lower in the corticosteroid-treated versus the placebo group (57 hours versus 120 hours, P = 0.035). The number of patients without norepinephrine 72 hours after inclusion was significantly lower in the treated group (P = 0.003, log-rank test analysis). The total quantities of norepinephrine administered to patients were lower in the hydrocortisone-treated versus the placebo group (1,205 μg/kg (1,079 to 2,167) versus 1,971 μg/kg (1,535 to 3,893), P = 0.067). There was no difference in terms of ICU or hospital length of stay, sepsis incidence, cicatrization or mortality.ConclusionsIn this placebo-controlled, randomized, double-blind clinical trial, we show for the first time that the administration of low-dose hydrocortisone in burn patients with severe shock reduces vasopressor administration.
Trial registration
Clinicaltrial.gov . Registered 6 September 2005. NCT00149123Electronic supplementary material
The online version of this article (doi:10.1186/s13054-015-0740-0) contains supplementary material, which is available to authorized users. 相似文献33.
Denis Friboulet Isabelle E. Magnin Didier Revel 《The International Journal of Cardiac Imaging》1992,8(3):175-190
In this paper we present a complete methodology to evaluate a model for overall three-dimensional (3D) motion of the human left ventricle (LV) from MRI data. The left ventricular motion is approximated by a linear model associated with an affine transformation to determine parameters for non-rigid motion of the LV. The proposed method has been applied to a normal patient and to a patient with cardiac disease. Results obtained show that the linear model provides a fairly good approximation of normal left ventricular motion, whereas serious cardiac disease produces abnormal motion, yielding altered model performances. 相似文献
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Lecoules S el Maghraoui A Damiano J Lechevalier D Magnin J Eulry F 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2002,23(5):454-459
INTRODUCTION: Half of the patients with genetic hemochromatosis will have arthritis. Two of these articular involvements are well-known: the arthropathy involving the phalangeal and the metacarpophalangeal joints of the hand, useful for diagnosis, and hip arthropathy. Iron deposits seem to be involved in articular cartilage destruction. EXEGESIS: We report five cases of patients with hemochromatosis hip involvement. Hip arthropathy revealed hemochromatosis in one case and appeared despite efficient phlebotomies in another case. Three of these patients required hip arthroplasty. CONCLUSION: Hip arthropathy remains a frequent but unknown event in genetic hemochromatosis (12.5%) and it involves the functional prognosis. 相似文献
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Hepatic dysfunction may be a manifestation of polymyalgia rheumatica. We present a second patient with the polymyalgia rheumatica syndrome and a significantly elevated alkaline phosphtase who, on liver biopsy, demonstrated granuloma formation and massive infiltration of the portal spaces with lymphocytes. The alkaline phosphatase elevation was favorably influenced by low dose steroid therapy. 相似文献
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