Effect of Hydrocortisone on Outcome of Post-Cardiac Arrest Between Road Traffic Accident Poly-Trauma Patients

Abstract

Background: Post-cardiac arrest carrying a very poor outcome especially after road traffic accident (RTA) between polytrauma patients. Corticosteroid used recently by many authors to improve outcome.

Objective: This study aimed to assess the effect of hydrocortisone on outcomes of cardiac arrest between RTA polytrauma patients.

Methods: This prospective, double-blinded, randomized controlled study enrolled 200 patients admitted to our ICU as post-cardiac arrest following RTA poly trauma. Patients were randomly allocated to either group A(n=100), received resuscitation according to advanced cardio-vascular life support (ACLS) protocol, group B (n=100) received same protocol with administration of hydrocortisone 200 mg intravenous (IV) state and 50 mg IV every 6 hours for 3 days. Number of patients died, re-arrested and revived, showed stunning heart on echocardiogram (echo), return of spontaneous circulation (ROSC) with vasopressor support, ROSC without vasopressor, had improvement in their Glasgow coma scale (GCS), showed normal tissue perfusion, developed coagulopathy were collected and compared.

Results: Patients in Groups B showed a significant improvement in all outcome parameters measured after cardiac arrest between RTA poly-trauma patients at the end of the studied period. As there was significant lower number of patients died, lower number of patients who developed re-arrest, lower number of patients who need high dose of inotropes to support ROSC and developed coagulopathy. And significant higher number of patients who showed improvement in their GCS and restored normal tissue perfusion.  

Conclusion: This study high light and clarify the effect of hydrocortisone in improving all outcome parameters measured after cardiac arrest between RTA poly-trauma patients as regard lowering number of patients died, re-arrest, showed post-arrest stunning myocardium, developed post-arrest coagulopathy and increasing number of patients who showed improved conscious level and restores normal tissue perfusion.