Association of early dexamethasone therapy with mortality in critically Ill COVID-19 patients: a French multicenter study

Autor: Matthieu Raymond, Aurélie Le Thuaut, Pierre Asfar, Cédric Darreau, Florian Reizine, Gwenhaël Colin, Charly Dano, Julien Lorber, Baptiste Hourmant, Agathe Delbove, Aurélien Frérou, Jean Morin, Pierre Yves Egreteau, Philippe Seguin, Jean Reignier, Jean-Baptiste Lascarrou, Emmanuel Canet
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Annals of Intensive Care, Vol 12, Iss 1, Pp 1-10 (2022)
Druh dokumentu: article
ISSN: 2110-5820
DOI: 10.1186/s13613-022-01074-w
Popis: Key messages What is already known on this topic Dexamethasone decreased day-28 mortality in the randomised controlled trial RECOVERY in patients admitted for COVID-19, including 74% who required oxygen and 16% invasive mechanical ventilation (iMV). Other trials targeting critically ill patients did not replicate this finding, leaving uncertainty about the benefits of dexamethasone. What this study adds In our large observational cohort of critically ill COVID-19 patients, of whom 61% required iMV, early systemic dexamethasone was not associated with lower day-28 mortality compared to no steroids. However, early dexamethasone was associated with less need for iMV, more days alive and off iMV, and a higher frequency of ventilator-associated pneumonia in the iMV sub-group. How this study might affect research, practice, or policy This study suggests that early dexamethasone may be warranted in critically ill COVID-19 patients, provided those receiving iMV are monitored closely for ventilatory-associated pneumonia.
Databáze: Directory of Open Access Journals
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