REVIEWING THE ROLE OF INTRAVENOUS STEROIDS IN BLUNT CHEST TRAUMA – LUNG CONTUSION
Keywords:Keywords: Pulmonary, Contusion, Steroids, Chest, Trauma
Background: Pulmonary contusion, which occurs in 25–35% of all blunt chest trauma, is usually caused by the rapid deceleration that results when the moving chest strikes a fixed object.
Objective: To see the effect of intravenous steroid in patients with blunt chest trauma- lung contusion and to compare the effect of steroid use based on improvement in oxygen saturation, ABG and hospital stay, in study group and control group.
Methodology: This study was conducted on 50 patients aged older than 5years and less than 80 years who had undergone blunt chest trauma by any mode of injury admitted from casualty. All patients attended in casualty and admitted, were monitored in ICU and given oxygen. All patients underwent routine blood and radiological investigations. All patients with radiologically proven lung contusion were divided in two groups (1) Steroid (study) group and (2) Non steroid (control) group on alternate basis of admission, with 25 sample size in each group. Study group patients were treated with steroid (hydrocortisone) 20mg/kg/day 6hourly which was tapered over time. Control group patients were treated in identical manner except steroid use. Both groups were studied for any improvement in parameters like Spo2, ABG, CT and Hospital stay.
Results: Most of the injuries affected the middle age group i.e from 25 – 65 years which accounted for total of 84%. Percentage of males and females in the study were 76% and 24% respectively. Most common mode of injury is road traffic accident which accounts for 76% as compared to non-road traffic accidents (24%). After statistical analysis of data, showed there was improvement in both groups in parameters like Spo2, ABG-Pco2, ABG-Sao2 which both were statistically significant and ABG-Po2, Radiological CT improvements, Hospital stay were statistically insignificant.
Conclusions: As both groups were showing improvements and there was no statistically much difference seen in both groups, we arrived to the conclusion that there is no role of iv steroid use in lung contusion. However, every patient must undergo CT for better assessment of injury. Objective scoring system are required in CT assessment of lung injury and studies with increased sample size and carried out at multiple centers are required for better conclusions.
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