Methylprednisolone as a prophylactic drug aginst multiple organ failure [MOF] in severely injured patients

ABSTRACT

The objective of this retrospective and prospective study was to assess the prophylactic use of mega doses of Methyl prednisolone to prevent Multiple Organ Failure [MOF] after sever trauma. Review of all severely injured patients who were admitted from Accident and Emergency Department to SICU in Hamad G. Hospital and to surgical dept. in Al Zahraa University Hospital in the period between Jan 1997 to May 1998. Eighty five patients were included based on an injury severity score [I.S.S.] of at least 36. The diagnosis of MOF was based on Multiple Organ Failure scoring system [adapted from Goris et al. 1985]. All patients had received I.V. bolus dose of M.P. [30 mg/kg, body weight within first 6 hours after trauma]. Most of the patients were in the 3 rd decade of life with mean age of [33 years]. Male sex was predominant [90.6%] and the Qatari people followed by the Egyptians occupied the highest number involved in this study [30.6%], [14.1%]. Road Traffic Accident was the most common mechanism of injury [68.2%] followed by Fall from height [21.2%]. The head was the most commonly injured organ [72.9%], followed by the limbs [40.0%], the chest [36.5%], then the abdomen and pelvis. All patients were thoroughly investigated both biochemically and radiologically. CT and MRI as well when indicated. Some patients were submitted to Diagnostic Peritoneal lavage [15.1%] and Ultra sound for [9.6%], one patient exposed to angiographic embolisation. 37 patients [43.5%], had different surgical procedures, craniotomy, chest procedure, laparotomy and orthopedic operations. 7 patients developed MOF [8.2%], within the first week. 85 severely injured patients given Methylprednisolone were studied retrospectively and prospectively. 7 patients [8.2%] developed MOF. This reflect an encouraging result for the use of Methyl prednisolone as a prophylactic drug against MOF in severe trauma patients taking in consideration a high incidence at different centers who are not using Methylprednisolone