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Catabolic Effect of Dexamethasone in Patients with Major Head Injuries
Author(s) -
Greenblatt Samuel H.,
Long Calvin L.,
Blakemore William S.,
Dennis Robert S.,
Rayport Mark,
Geiger John W.
Publication year - 1989
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607189013004373
Subject(s) - dexamethasone , medicine , glasgow coma scale , catabolism , significant difference , nitrogen balance , head trauma , anesthesia , surgery , metabolism , chemistry , organic chemistry , nitrogen
In the records of our extensive metabolic studies on trauma victims, we found 16 head injured patients who had no other major injuries. Among them, nine had been given dexamethasone for at least 6 days. The other seven had not received any corticosteroids. There was no significant difference in the Glasgow Coma Scales of the treated and untreated groups. Metabolic balance studies were carried out for at least 3 days, including the periods when the treated patients were receiving dexamethasone. Mean nitrogen balance was ‐0.296 ± 0.03 g/kg/day for the treated group and ‐0.182 ± 0.03 g/kg/ day for the untreated group. This difference was significant ( p = 0.02, t‐test). Our metabolic data are also consistent with those of other published studies, which used other corticosteroids and somewhat different methodologies. Thus, it is clearly established that corticosteroids cause significant degrees of catabolism in head injured patients, beyond what would “normally” be expected in such patients if they did not receive these drugs. ( Journal of Parenteral and Enteral Nutrition 13: 372–376, 1989)