Abstract
In last years an increasing number of evidences has been gained that inflammatory response plays a major role in critical illness. The acronym SIRS (Systemic Inflammatory Response Syndrome) has been introduced to define the condition in which the inflammatory reaction exceeds local mechanisms of containment and inflammatory mediators invade the bloodstream causing systemic disturbances. Theoretically, the use of corticosteroids offers a potent tool to control the excess of inflammatory reaction, but initial trials on Adult Respiratory Distress Syndrome (ARDS), head trauma, and septic shock showed not only that mortality was unaffected, but also that morbidity could increase. Recently, however, some new studies have suggested that corticosteroids given at dosages lower than those initially tested, could positively affect late stages of ARDS by preventing pulmonary fibrosis, and septic shock by improving hemodynamics and facilitating the weaning from catecholamines. To date, it is not clear whether these effects are related to the correction of an adrenocortical dysfunction.
Keywords: corticosteroids, systemic inflammatory response syndrome, sirs, adult respiratory distress syndrome, ards, sepsis, septic shock, head trauma
Current Drug Targets
Title: New Indications for Corticosteroids in Intensive Care Units
Volume: 5 Issue: 5
Author(s): Franco Cavaliere, Simonetta Masieri, Giuseppina Annetta, Flavio Gargano and Rodolfo Proietti
Affiliation:
Keywords: corticosteroids, systemic inflammatory response syndrome, sirs, adult respiratory distress syndrome, ards, sepsis, septic shock, head trauma
Abstract: In last years an increasing number of evidences has been gained that inflammatory response plays a major role in critical illness. The acronym SIRS (Systemic Inflammatory Response Syndrome) has been introduced to define the condition in which the inflammatory reaction exceeds local mechanisms of containment and inflammatory mediators invade the bloodstream causing systemic disturbances. Theoretically, the use of corticosteroids offers a potent tool to control the excess of inflammatory reaction, but initial trials on Adult Respiratory Distress Syndrome (ARDS), head trauma, and septic shock showed not only that mortality was unaffected, but also that morbidity could increase. Recently, however, some new studies have suggested that corticosteroids given at dosages lower than those initially tested, could positively affect late stages of ARDS by preventing pulmonary fibrosis, and septic shock by improving hemodynamics and facilitating the weaning from catecholamines. To date, it is not clear whether these effects are related to the correction of an adrenocortical dysfunction.
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Cavaliere Franco, Masieri Simonetta, Annetta Giuseppina, Gargano Flavio and Proietti Rodolfo, New Indications for Corticosteroids in Intensive Care Units, Current Drug Targets 2004; 5 (5) . https://dx.doi.org/10.2174/1389450043345362
DOI https://dx.doi.org/10.2174/1389450043345362 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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