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sábado, 13 de julio de 2013

Trauma medular: no dar esteroides!

Shaw G. Emergency Medicine News: July 2013: 35 (7): 1.31-31
doi: 10.1097/01.EEM.0000432258.95792.d9
"New evidence-based recommendations from two neurological associations for treating acute spine and spinal cord injuries in adults state unequivocally that methylprednisolone is not recommended. The document from the American Association of Neurological Surgeons and the Congress of Neurological Surgeons goes on to add that high-dose steroids are associated with harmful side effects, including death. (Neurosurgery 2013;72[3]:93.)
These conclusions probably won't surprise many neurosurgeons or many emergency physicians, for that matter, and certainly not most of those who work in hospitals with trauma centers. A literature search for “methylprednisolone” and “spinal cord injury” quickly yields papers that call the drug “an inappropriate standard of care,” label its usefulness as a “myth,” and point out its “failure” to improve outcome."

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