流感重症,不要用類固醇
severe H1N1 infection, 今年冬季大家領教過了吧…… 歐洲的觀察,用steroid trying to decrease cytokine storm是無益的 會增加肺炎機會 個人見解: 這次流感的ARDS 60-70歲以上的病人,除非underlying太差,雖敗不亂,用呼吸器可以徐圖漸進,日日有起色,眼睛烏亮亮,不會讓你想用類固醇 30-40歲的人,一來就撐不住,馬上轉到敏盛/長庚用ECMO,用啥都沒用 either case -> 都用不到 steroid Severe H1N1 Influenza Infection: Hold the Corticosteroids! An observational European study shows that corticosteroids increased risk for pneumonia and conferred no mortality benefit in patients with severe H1N1 infection. Use of corticosteroids to mitigate the cytokine storm that might contribute to poor outcomes in otherwise healthy people with pandemic H1N1 influenza infection is controversial, even in those with acute respiratory distress syndrome (ARDS). In a prospective observational study, investigators evaluated the effect of corticosteroids on outcomes in 220 intensive care unit (ICU) patients who were enrolled in the European Society of Intensive Care Medicine H1N1 registry from June 2009 through February 2010. H1N1 influenza A infect...