Corticothérapie systémique et pneumopathies communautaires : où en est-on ?

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• 作者：P. F. Dequin
• 关键词：Mots clésPneumopathie aiguë communautaire ; Corticostéroïdes ; Réanimation ; Pronostic ; Méta ; analyses
• 刊名：Médecine Intensive Réanimation
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：26
• 期：1
• 页码：48-55
• 全文大小：
• 刊物主题：Emergency Medicine; Anesthesiology; Intensive / Critical Care Medicine;
• 出版者：Lavoisier
• ISSN：1951-6959
• 卷排序：26

文摘

Mortality of severe community-acquired pneumonia (CAP) has not declined over time and is between 25 and 30% in sub-groups of patients. Corticosteroids (CTx) could down-regulate pulmonary and systemic inflammation, accelerate clinical resolution and decrease the rate of inflammation-associated systemic complications. Some randomized controlled trials have suggested that CTx could decrease time to clinical stability and length of stay. Recent meta-analyses suggest an increase in severe CAP survival when CTx are added to standard therapy. However they are based on very few trials gathering less than 400 patients. At this time, guidelines do not recommend CTx as part of CAP treatment. However well-powered trials are underway and will hopefully help to answer this question.