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Article: High-Dose Pulse Versus Nonpulse Corticosteroid Regimens in Severe Acute Respiratory Syndrome

TitleHigh-Dose Pulse Versus Nonpulse Corticosteroid Regimens in Severe Acute Respiratory Syndrome
Authors
KeywordsCorticosteroid
Ribavirin
Severe acute respiratory syndrome
Issue Date2003
PublisherAmerican Thoracic Society. The Journal's web site is located at http://ajrccm.atsjournals.org
Citation
American Journal Of Respiratory And Critical Care Medicine, 2003, v. 168 n. 12, p. 1449-1456 How to Cite?
AbstractThe treatment of atypical pneumonia, subsequently termed severe acute respiratory syndrome (SARS), is controversial, and the efficacy of corticosteroid therapy is unknown. We have evaluated the clinical and radiographic outcomes of 72 patients with probable SARS (median age 37 years, 30 M), who received ribavirin and different steroid regimens in two regional hospitals. Chest radiographs were scored according to the percentage of lung field involved. Seventeen patients initially received pulse steroid (PS) (methylprednisolone ≥ 500 mg/day) and 55 patients initially received nonpulse steroid (NPS) (methylprednisolone < 500 mg/day) therapy. The cumulative steroid dosage; intensive care unit admission, mechanical ventilation, and mortality rates; and hematologic and biochemical parameters were similar in both groups after 21 days. However, patients in the PS group had less oxygen requirement, better radiographic outcome, and less likelihood of requiring rescue PS therapy than their counterparts. There was no significant difference between the two groups in hemolytic anemia, severe secondary infections, or hematemesis, but patients in the PS group had less hyperglycaemia. Initial use of pulse methylprednisolone therapy appears to be a more efficacious and an equally safe steroid regimen when compared with regimens with lower dosage and should be considered as the preferred steroid regimen in the treatment of SARS, pending data from future randomized controlled trials.
Persistent Identifierhttp://hdl.handle.net/10722/78423
ISSN
2015 Impact Factor: 13.118
2015 SCImago Journal Rankings: 5.832
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHo, JCen_HK
dc.contributor.authorOoi, GCen_HK
dc.contributor.authorMok, TYen_HK
dc.contributor.authorChan, JWen_HK
dc.contributor.authorHung, Ien_HK
dc.contributor.authorLam, Ben_HK
dc.contributor.authorWong, PCen_HK
dc.contributor.authorLi, PCen_HK
dc.contributor.authorHo, PLen_HK
dc.contributor.authorLam, WKen_HK
dc.contributor.authorNg, CKen_HK
dc.contributor.authorIp, MSen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorChanYeung, Men_HK
dc.contributor.authorTsang, KWen_HK
dc.date.accessioned2010-09-06T07:42:43Z-
dc.date.available2010-09-06T07:42:43Z-
dc.date.issued2003en_HK
dc.identifier.citationAmerican Journal Of Respiratory And Critical Care Medicine, 2003, v. 168 n. 12, p. 1449-1456en_HK
dc.identifier.issn1073-449Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/78423-
dc.description.abstractThe treatment of atypical pneumonia, subsequently termed severe acute respiratory syndrome (SARS), is controversial, and the efficacy of corticosteroid therapy is unknown. We have evaluated the clinical and radiographic outcomes of 72 patients with probable SARS (median age 37 years, 30 M), who received ribavirin and different steroid regimens in two regional hospitals. Chest radiographs were scored according to the percentage of lung field involved. Seventeen patients initially received pulse steroid (PS) (methylprednisolone ≥ 500 mg/day) and 55 patients initially received nonpulse steroid (NPS) (methylprednisolone < 500 mg/day) therapy. The cumulative steroid dosage; intensive care unit admission, mechanical ventilation, and mortality rates; and hematologic and biochemical parameters were similar in both groups after 21 days. However, patients in the PS group had less oxygen requirement, better radiographic outcome, and less likelihood of requiring rescue PS therapy than their counterparts. There was no significant difference between the two groups in hemolytic anemia, severe secondary infections, or hematemesis, but patients in the PS group had less hyperglycaemia. Initial use of pulse methylprednisolone therapy appears to be a more efficacious and an equally safe steroid regimen when compared with regimens with lower dosage and should be considered as the preferred steroid regimen in the treatment of SARS, pending data from future randomized controlled trials.en_HK
dc.languageengen_HK
dc.publisherAmerican Thoracic Society. The Journal's web site is located at http://ajrccm.atsjournals.orgen_HK
dc.relation.ispartofAmerican Journal of Respiratory and Critical Care Medicineen_HK
dc.subjectCorticosteroiden_HK
dc.subjectRibavirinen_HK
dc.subjectSevere acute respiratory syndromeen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAnti-Inflammatory Agents - administration & dosageen_HK
dc.subject.meshAntiviral Agents - therapeutic useen_HK
dc.subject.meshCohort Studiesen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMethylprednisolone - administration & dosageen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPulse Therapy, Drug - methodsen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshRibavirin - therapeutic useen_HK
dc.subject.meshSevere Acute Respiratory Syndrome - drug therapyen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleHigh-Dose Pulse Versus Nonpulse Corticosteroid Regimens in Severe Acute Respiratory Syndromeen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1073-449X&volume=168&spage=1449&epage=1456&date=2003&atitle=High-dose+pulse+versus+nonpulse+corticosteroid+regimens+in+severe+acute+respiratory+syndromeen_HK
dc.identifier.emailHo, JC: jhocm@hku.hken_HK
dc.identifier.emailHung, I: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailHo, PL: plho@hkucc.hku.hken_HK
dc.identifier.emailIp, MS: msmip@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityHo, JC=rp00258en_HK
dc.identifier.authorityHung, I=rp00508en_HK
dc.identifier.authorityHo, PL=rp00406en_HK
dc.identifier.authorityIp, MS=rp00347en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1164/rccm.200306-766OCen_HK
dc.identifier.pmid12947028-
dc.identifier.scopuseid_2-s2.0-9144258533en_HK
dc.identifier.hkuros86221en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-9144258533&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume168en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1449en_HK
dc.identifier.epage1456en_HK
dc.identifier.isiWOS:000187215700014-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridHo, JC=7402649981en_HK
dc.identifier.scopusauthoridOoi, GC=7006176119en_HK
dc.identifier.scopusauthoridMok, TY=8706357200en_HK
dc.identifier.scopusauthoridChan, JW=34967874700en_HK
dc.identifier.scopusauthoridHung, I=7006103457en_HK
dc.identifier.scopusauthoridLam, B=9246012800en_HK
dc.identifier.scopusauthoridWong, PC=7403979916en_HK
dc.identifier.scopusauthoridLi, PC=36068280500en_HK
dc.identifier.scopusauthoridHo, PL=7402211363en_HK
dc.identifier.scopusauthoridLam, WK=7203021937en_HK
dc.identifier.scopusauthoridNg, CK=36747474400en_HK
dc.identifier.scopusauthoridIp, MS=7102423259en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridChanYeung, M=54790582200en_HK
dc.identifier.scopusauthoridTsang, KW=7201555024en_HK

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