RT Journal Article
SR Electronic
T1 Dexamethasone for treatment of patients mechanically ventilated for lower respiratory tract infection caused by respiratory syncytial virus
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 383
OP 387
DO 10.1136/thorax.58.5.383
VO 58
IS 5
A1 J B M van Woensel
A1 W M C van Aalderen
A1 W de Weerd
A1 N J G Jansen
A1 J P J van Gestel
A1 D G Markhorst
A1 A J van Vught
A1 A P Bos
A1 J L L Kimpen
YR 2003
UL http://thorax.bmj.com/content/58/5/383.abstract
AB Background: A study was undertaken to evaluate the efficacy of dexamethasone in patients mechanically ventilated for lower respiratory infection caused by respiratory syncytial virus (RSV-LRTI). Methods: In a multicentre randomised controlled trial patients were randomised to receive either intravenous dexamethasone (0.15 mg/kg 6 hourly for 48 hours) or placebo. End points were the duration of mechanical ventilation, length of stay (LOS) in the pediatric intensive care unit (PICU) and in hospital, and the duration of supplemental oxygen administration. Results: Thirty seven patients received dexamethasone and 45 received placebo. There was no significant difference in any of the end points between the two groups. In a post hoc analysis patients were stratified into those with mild gas exchange anomalies (Pao2/Fio2 >200 mm Hg and/or mean airway pressure ⩽ 10 cm H2O, bronchiolitis group) and those with severe gas exchange anomalies (Pao2/Fio2 ⩽200 mm Hg and mean airway pressure >10 cm H2O, pneumonia group). In the 39 patients with bronchiolitis the duration of mechanical ventilation was 4.3 days shorter in the dexamethasone group than in the placebo group (4.9 v 9.2 days, 95% CI −7.8 to −0.8, p=0.02) and the duration of supplemental oxygen was 3.6 days shorter (7.7 v 11.3 days, 95% CI −8.0 to −0.1, p=0.048). No differences in end points were found in the pneumonia group. Conclusions: Dexamethasone had no beneficial effect in patients mechanically ventilated for RSV-LRTI but was found to have a beneficial effect in patients with bronchiolitis.