Authors: Christian Sabbagh, Kevin Sneed, Yashwant V Pathak.
Secondary infections such as nosocomial pneumonia are one of the highest causes of mortalities for critically ill trauma patients in a hospital. Prevention practices have been appropriately placed in order to lower infection rates. However, clinical data suggests that little improvement of nosocomial pneumonia infections have occurred because of prevention practices. New groundbreaking research of hydrocortisone therapy for trauma patients has shown to be successful in improving not only patient outcomes, but decreasing time with mechanical ventilation and decrease in total hospital days. Hydrocortisone therapy is effective because critically injured patients suffer from a condition called critical injury-related corticosteroid insufficiency (CIRCI). In this condition, the natural proinflammatory response is heavily exaggerated and takes an exacerbated toll on the body of a patient. The natural anti-inflammatory steroids that are normally produced in stress events such as cortisol is severely diminished or nonexistent. Therefore, with the exaggerated inflammatory response, the chances of contracting secondary infections such as nosocomial or ventilator-acquired pneumonia are heightened drastically. Data from clinical research studies have shown that stress dose levels of cortisol therapy for critically injured patients have shown to be efficacious in lowering risks of secondary infection. Furthermore, due to fewer days in the hospital, there is less stress on the limited capacity of an emergency department of a hospital. Moreover, patients are saving $5,000 to $20,000 from avoiding excessive medical expenses that would result from more hospital stays.
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