Steroids in spinal cord injury ?

[Ronald Gross]

Simple answer - steroids have NO USE in SCI, nor do they have a role in closed head injury.
I can't wait to hear what Ken Mattox has to say.....   ;-)

Take care,
Ron

>>> Ivan Hronek <ivanhronek at yahoo.com> 4/23/2008 12:03 AM >>>
Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. 
I got an approval from Sandy Miller to post this here, anyone feels strongly about it ?



At the PGA (Postgraduate Assembly of the NYSSA)last December, the 
question came up in a discussion during a panel (I missed the main 
talk because of another meeting).

This is for those who deal with acute spinal cord injured patients. 
The question asked was: given a patient who is both head and spinal 
cord injured,would you use megadose steroids? To my surprise--and 
shock--the panelist answered yes. I didn't get a chance to make a 
comment myself because time was up.

Now, I had thought that it was generally understood by now that the 
evidence for any good effect of steroids in SCI is at best 
questionable, and that the evidence for harm from steroids in acute 
brain injury is unequivocable. Hence my shock. Certainly, if you have 
to be most concerned with any injury, one to the brain should be at 
the top of the list.

So, my question for the list: does anyone still use megadose steroids 
for spinal cord injured pts? If so, why? If not, why not? If you have 
a pt with SCI who also has a head injury, would you use them then? If 
so, why?

Shameful self-promotion: I have an article on this in the current 
issue of Jopurnal of Neurosurgical Anesthesiology, and just finished 
our chapter on Trauma and Burns for the next issue of Barash, so I 
have gone over the literature pretty thoroughly. I'll post some 
references if you like; I'm running out of time now.

Sanford M. Miller, MD

 
Ivan Hronek MD 
SFMC, Los Angeles
cell: 310 487-3288
http://health.groups.yahoo.com/group/Anesthideas/ 
Your most unhappy customers are your greatest source of learning. Bill Gates.
P Please don't print this e-mail unless you really need to.



Confidentiality Notice: This transmission and any attached documents may be confidential and contain information protected by State and Federal Medical Privacy statutes and is legally privileged. They are intended for use only by the addressee. If you are not the intended recipient of this transmission, or an agent of the intended recipient, you are prohibited from reading, disclosing, printing, saving, copying, using, or otherwise disseminating any information contained in this transmission. If you received this transmission in error, please accept our apologies and notify me at  ivanhronek at yahoo.com and delete the entire message and its attachments. Thank you. Disclaimer: this message contains the personal views of the author. The author will not be responsible in any way for procedures or approaches perfomed in the way suggested in this note. 



 


      ____________________________________________________________________________________
Be a better friend, newshound, and 
know-it-all with Yahoo! Mobile.  Try it now.  http://mobile.yahoo.com/;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ 
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/