NEW YORK (Reuters Health) – Hydrocortisone therapy may lower the risk of nosocomial pneumonia in severe trauma patients, according to new research from France.

The study also found that hydrocortisone treatment was linked with shorter hospital stays and a smaller risk of acute lung injury and acute respiratory distress, but not with lower mortality rates.

Led by Dr. Antoine Roquilly of the University of Nantes, researchers randomly assigned 149 patients with multiple trauma at seven different French intensive care units to receive continuous intravenous hydrocortisone or a placebo.

Hydrocortisone was infused at 200 mg/day for 5 days, then at 100mg on day 6 and 50mg on day 7. Drug infusion began within 36 hours of trauma, and was stopped early in patients who did not have a corticosteroid insufficiency, as measured by a short corticotropin test.

The results are published in JAMA.

Eight-six percent of patients had surgery before they were randomized. Patients in the hydrocortisone group had a median injury severity score of 29 (out of 75), compared to 27 in the placebo group.

In an analysis including all patients, 35.6% of those treated with hydrocortisone and 51.3% in the placebo group developed nosocomial pneumonia by day 28 of hospitalization (p = 0.007). Rates were similar, and also significant, when the authors limited the analysis to the 113 patients with corticosteroid insufficiency.

Also in the intention-to-treat analysis, acute lung injury or acute respiratory distress syndrome was diagnosed in 4.1% of patients on hydrocortisone and 14.5% of those treated with the placebo. Hydrocortisone patients had an average ICU stay of 18 days, compared to 24 days for the placebo group.

There was not a significant difference in death rates in the two groups