Steroids Given in ICU Increase Risk of Delirium
Critically
ill patients who receive steroids in intensive care units (ICUs) of
hospitals have more chances of developing delirium, a study by John
Hopkins Medicine shows.
Delirium leads to poor memory and thinking, sometimes with disorientation, hallucinations and agitation. For the study, researchers analyzed the medical records of 330 acute lung injury patients with a collective 2,286 days in an ICU at four Baltimore hospitals between October 2004 and October 2007. They found that patients had 52 percent more chances of developing delirium if they were treated with steroids on the previous day.
Moreover, the chances of delirium increased with age, the researchers found.
Researchers said that delirium generally goes away after a few days but studies show delirium in the ICU has a long-term impact. Overall, up to 80 percent of ventilated patients develop delirium in the ICU, and researchers have been looking for risk factors.
This study found that in more than one-third of the ICU days evaluated, mechanically ventilated patients with acute lung injury were given systemic corticosteroids at a range of doses during their ICU stay.
"We need to be cautious in our use of steroids in critically ill patients and weigh the risks and benefits of using them," said lead author Dale M. Needham, an associate professor of medicine and of physical medicine and rehabilitation at the Johns Hopkins University School of Medicine. "Sometimes they are necessary, but we need to be thoughtful about minimizing the dose and duration of steroid use when possible," he said in a press release.
He explained that there are plenty of reasons why an ICU patient is given steroids. They may be ordered to respond to inflammation in the lung or elsewhere in the body. Steroids were also often used often to treat septic shock in the ICU, but more recent studies have shown fewer benefits from steroids in this condition.
Delirium leads to poor memory and thinking, sometimes with disorientation, hallucinations and agitation. For the study, researchers analyzed the medical records of 330 acute lung injury patients with a collective 2,286 days in an ICU at four Baltimore hospitals between October 2004 and October 2007. They found that patients had 52 percent more chances of developing delirium if they were treated with steroids on the previous day.
Moreover, the chances of delirium increased with age, the researchers found.
Researchers said that delirium generally goes away after a few days but studies show delirium in the ICU has a long-term impact. Overall, up to 80 percent of ventilated patients develop delirium in the ICU, and researchers have been looking for risk factors.
This study found that in more than one-third of the ICU days evaluated, mechanically ventilated patients with acute lung injury were given systemic corticosteroids at a range of doses during their ICU stay.
"We need to be cautious in our use of steroids in critically ill patients and weigh the risks and benefits of using them," said lead author Dale M. Needham, an associate professor of medicine and of physical medicine and rehabilitation at the Johns Hopkins University School of Medicine. "Sometimes they are necessary, but we need to be thoughtful about minimizing the dose and duration of steroid use when possible," he said in a press release.
He explained that there are plenty of reasons why an ICU patient is given steroids. They may be ordered to respond to inflammation in the lung or elsewhere in the body. Steroids were also often used often to treat septic shock in the ICU, but more recent studies have shown fewer benefits from steroids in this condition.
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Labels: agitation, chance, delirium, developing, disoriented, hallucinations, ICU, poor memory, steroid
posted by G S Iyer at 10:06 PM
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