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Hormone Therapy in Trauma Patients.

Karim Asehnoune1, Mickael Vourc'h1, Antoine Roquilly1

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|February 21, 2019
PubMed
Summary

Low-dose hydrocortisone effectively reduces vasopressor needs and hospital stay for critically ill patients. Monitoring blood glucose and sodium is advised, but major side effects are uncommon with this hormone therapy.

Keywords:
CorticosteroidsCritical illnessErythropoietinLow-dose hydrocortisoneProgesteroneTrauma patientsTraumatic brain injury

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Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Hormone therapy is explored for critical illness, with varying results across agents.
  • Glucocorticoids, particularly hydrocortisone, show promise in managing specific intensive care unit (ICU) complications.

Purpose of the Study:

  • To review the efficacy and safety of various hormone therapies in critical care.
  • To focus on the role of glucocorticoids in improving outcomes for critically ill patients.

Main Methods:

  • Literature review and meta-analysis of studies investigating hormone treatments in critical illness.
  • Analysis of outcomes such as vasopressor requirements, length of stay, infection rates, and mortality.

Main Results:

  • Low-dose hydrocortisone decreases vasopressor use, shortens hospital stays, and may reduce pneumonia and ventilator time.
  • Oxandrolone is linked to shorter hospital stays and reduced weight loss.
  • Erythropoietin did not improve neurological outcomes in traumatic brain injury but showed mortality benefits in specific subgroups.

Conclusions:

  • Low-dose hydrocortisone is a beneficial hormone therapy in critical care, requiring monitoring of glycemia and natremia.
  • Other hormones like progesterone and erythropoietin have shown limited or specific benefits.
  • Glucocorticoids represent the most studied hormone class for critical care interventions.