{"id":25290,"date":"2024-02-07T04:55:00","date_gmt":"2024-02-06T20:55:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25290"},"modified":"2024-02-07T05:27:35","modified_gmt":"2024-02-06T21:27:35","slug":"intensive-care-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%99%a2%e5%89%8d%e5%a4%a7%e5%89%82%e9%87%8f%e7%94%b2%e5%bc%ba%e9%be%99%e6%b2%bb%e7%96%97%e5%a4%8d%e8%8b%8f%e5%90%8e%e7%9a%84%e9%99%a2","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25290","title":{"rendered":"[Intensive Care Med\u53d1\u8868\u8bba\u6587]\uff1a\u9662\u524d\u5927\u5242\u91cf\u7532\u5f3a\u9f99\u6cbb\u7597\u590d\u82cf\u540e\u7684\u9662\u5916\u5fc3\u8df3\u9aa4\u505c\u60a3\u8005"},"content":{"rendered":"\n

Prehospital high-dose methylprednisolone in resuscitated out-of-hospital cardiac arrest patients (STEROHCA): a randomized clinical trial<\/h1>\n\n\n\n

Obling, L.E.R., Beske, R.P., Meyer, M.A.S.\u00a0et al.<\/em><\/h3>\n\n\n\n

Intensive Care Med 2023;\u00a049: 1467\u20131478<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Purpose<\/h3>\n\n\n\n

Patients who are successfully resuscitated following out-of-hospital cardiac arrest (OHCA) are still at a high risk of neurological damage and death. Inflammation and brain injury are components of the post-cardiac arrest syndrome, and can be assessed by systemic interleukin 6 (IL-6) and neuron-specific enolase (NSE). Anti-inflammatory treatment with methylprednisolone may dampen inflammation, thereby improving outcome. This study aimed to determine if prehospital high-dose methylprednisolone could reduce IL-6 and NSE in comatose OHCA patients.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

The STEROHCA trial was a randomized, blinded, placebo-controlled, phase II prehospital trial performed at two cardiac arrest centers in Denmark. Resuscitated comatose patients with suspected cardiac etiology were randomly assigned 1:1 to a single intravenous injection of 250 mg methylprednisolone or placebo. The co-primary outcome was reduction of IL-6 and NSE-blood levels measured daily for 72 h from admission. The main secondary outcome was survival at 180 days follow-up.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

We randomized 137 patients to methylprednisolone (n<\/em>\u2009=\u200968) or placebo (n<\/em>\u2009=\u200969). We found reduced IL-6 levels (p<\/em>\u2009<\u20090.0001) in the intervention group, with median (interquartile range, IQR) levels at 24\u00a0h of 2.1\u00a0pg\/ml (1.0; 7.1) and 30.7\u00a0pg\/ml (14.2; 59) in the placebo group. We observed no difference between groups in NSE levels (p<\/em>\u2009=\u20090.22), with levels at 48\u00a0h of 18.8 ug\/L (14.4; 24.6) and 14.8 ug\/L (11.2; 19.4) in the intervention and placebo group, respectively. In the intervention group, 51 (75%) patients survived and 44 (64%) in the placebo group.<\/p>\n\n\n\n

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Conclusion<\/h3>\n\n\n\n

Prehospital treatment with high-dose methylprednisolone to resuscitated comatose OHCA patients, resulted in reduced IL-6 levels after 24 h, but did not reduce NSE levels.<\/p>\n","protected":false},"excerpt":{"rendered":"

Prehospital high-dose methylprednisolone in resuscitate […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25290"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25290"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25290\/revisions"}],"predecessor-version":[{"id":25291,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25290\/revisions\/25291"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25290"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25290"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25290"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}