Research Information System
EGE 7th INTERNATIONAL CONFERENCE ON APPLIED SCIENCES, İzmir, Turkey, 24 - 25 December 2022, pp.489-499
The aim of our study is to evaluate the clinical and laboratory results of two different dexamethasone treatment protocols (6 mg and 20 mg) in ARDS patients followed up with COVID-19 in the intensive care units by comparing them retrospectively. Patients diagnosed with COVID-19 infection and treated with corticosteroid (dexamethasone) in the Anesthesiology and Reanimation Pandemic Intensive Care Units of Kütahya Health Sciences University Faculty of Medicine between 01.08.2020 and 01.03.2021 were included in this study. The dose of corticosteroid to be given was decided and applied by, except fort he doctors who conducted this study, their specialist physicians who took the primary treatment of the patients in the intensive care units and by considering the current guidelines, publications and clinical statues of the patients. The researchers were not included in the treatment planning of the patients. The patients were divided into two groups by the researchers; Group 1: receiving 6 mg/day dexamethasone treatment (n:41), Group 2: receiving 0-5 days 20 mg/day and 6-10 days 10 mg/day dexamethasone treatment (n:39). The clinical results and laboratory values between the groups were compared on days zero and ten. 45% of the patients were female and 55% were male. There was no significant difference between the groups in terms of age, comorbid disease, intubation days, intensive care unit stay, hospital stay and death days in intensive care. In patients given 20 mg dexamethasone, APACHE II scores on day 0 and invasive mechanical ventilation support were found to be significantly higher (one by one p:0.039 and p:0.008). When the 0th and 10th day parameter changes of the patients after ten days of dexamethasone treatment in the intensive care unit were examined, it was determined that the procalcitonin and D-Dimer values in the 20 mg group showed a statistically significant increase compared to the 6 mg group (p:0.038 and p:0.025). There was found no difference in ventilation parameters between the two groups. And finally, the effect of dexamethasone treatment on mortality was examined and no difference was found between the groups. As a result, dexamethasone treatment improves clinical and laboratory parameters in ARDS patients followed in COVID-19 intensive care units. However in terms of benefit/harm ratio and side effects; we can think that 6 mg dexamethasone treatment can be preferred to 20 mg dexamethasone treatment because it controls inflammation and creates less disadvantage for susceptibility to infection.
Keywords: Anesthesiology and Reanimation, Intensive Care, Covid, ARDS, Dexamethasone