This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (66)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Michael Jastremski, MD; Kim Sutton-Tyrrell, DrPH; Per Vaagenes, MD; Norman Abramson, MD; Darell Heiselman, DO; Peter Safar, MD; Brain Resuscitation Clinical Trial I Study Group

JAMA. 1989;262(24):3427-3430.

Abstract
Glucocorticoids are commonly given to patients with global brain ischemia, although their efficacy has not been proved. The database of the Brain Resuscitation Clinical Trial I, a multi-institutional study designed to evaluate the effect of thiopental sodium therapy on neurological outcome following brain ischemia, was used for a retrospective review of the effects of glucocorticoid treatment on neurological outcome after global brain ischemia. This study included 262 initially comatose cardiac arrest survivors who made no purposeful response to pain after restoration of spontaneous circulation. The standard treatment protocol left glucocorticoid therapy to the discretion of the hospital investigators. This resulted in four patient groups that received either no, low, medium, or high doses of glucocorticoids in the first 8 hours after arrest. Neurological outcome was scored using a modification of the Glasgow Cerebral Performance Category Scale. None of the steroid regimens statistically improved mean group survival rate or neurological recovery rate over that observed in the group that did not receive steroids. The routine clinical practice of administrating glucocorticoids after global brain ischemia may be associated with serious complications and is not justified.

(JAMA. 1989;262:3427-3430)

Author Affiliations
From the International Resuscitation Research Center, University of Pittsburgh (Pa).

Footnotes
Reprint requests to Department of Critical Care and Emergency Medicine, State University of New York Health Science Center, 750 E Adams St, Syracuse, NY 13210 (Dr Jastremski).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The use of mice and rats as animal models for cardiopulmonary resuscitation research
Papadimitriou et al.
Lab Anim 2008;42:265-276.
ABSTRACT | FULL TEXT  

Therapeutic Hypothermia after Cardiac Arrest
Rincon
ANN INTERN MED 2008;148:485-486.
FULL TEXT  

Cerebral protection
Fukuda and Warner
Br J Anaesth 2007;99:10-17.
ABSTRACT | FULL TEXT  

Neurologic prognosis and withdrawal of life support after resuscitation from cardiac arrest.
Geocadin et al.
Neurology 2006;67:105-108.
ABSTRACT | FULL TEXT  

Outcomes After Ventricular Fibrillation Out-of-Hospital Cardiac Arrest: Expanding the Chain of Survival
Bunch et al.
Mayo Clin Proc. 2005;80:774-782.
ABSTRACT  

Coenzyme Q10 Combined With Mild Hypothermia After Cardiac Arrest: A Preliminary Study
Damian et al.
Circulation 2004;110:3011-3016.
ABSTRACT | FULL TEXT  

Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia
Bernard et al.
NEJM 2002;346:557-563.
ABSTRACT | FULL TEXT  

Emergency cardiac care: introduction
Ewy and Ornato
J Am Coll Cardiol 2000;35:825-880.
FULL TEXT  

Nimodipine After Resuscitation From Out-of-Hospital Ventricular Fibrillation: A Placebo-Controlled, Double-Blind, Randomized Trial
Roine et al.
JAMA 1990;264:3171-3177.
ABSTRACT  

STEROIDS ARE NOT BENEFICIAL FOR CEREBRAL ISCHEMIA AFTER CARDIAC ARREST
JWatch General 1989;1989:3-3.
FULL TEXT