Role of high-dose methylprednisolone in Zargar Grade IIB corrosive esophageal burns : A randomized control study
Copyright: © 2024 Turkish Journal of Emergency Medicine..
OBJECTIVE: The objective of the study is to test the efficacy of high-dose methylprednisolone in the prevention of esophageal stricture after corrosive ingestion.
METHODS: This study was a single-center, randomized controlled single-blinded study. Simple randomization was done with 15 adult patients (>18 years) in each arm, who presented with a history of corrosive ingestion within the past 24 h and had esophageal injury of Zargar Grade IIB on endoscopy. Intravenous methylprednisolone 1 g/day for 3 days was given to the intervention arm while 100 mL of normal saline was given as placebo in control arm. Follow-up to diagnose esophageal stricture was done at 8 weeks.
RESULTS: Thirty patients (15 in each arm) were recruited for the study. As per the intention to treat analysis, 33% and 46.6% developed stricture in the intervention and control arm, respectively (relative risk [RR] = 0.714; 95% confidence interval 0.29-1.75; P = 0.462). 40% patients in control group and 7.7% in intervention group had undergone feeding jejunostomy, which was statistically significant with a p-value of 0.048. Airway injury showed significant clinical improvement in the intervention arm but the difference was nonsignificant statistically (P = 0.674). There was no increased incidence of hypertension, hyperglycemia, hyponatremia, hyperkalemia, or infections in intervention arm.
CONCLUSION: Methylprednisolone does not help in the prevention of stricture formation in corrosive esophageal injury, but it significantly reduces the requirement of feeding jejunostomy and has a beneficial role in treating airway injury.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
Turkish journal of emergency medicine - 24(2024), 1 vom: 15. Jan., Seite 20-26 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sheikh, Irtiqa [VerfasserIn] |
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| Links: |
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| Themen: |
Airway injury |
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| Anmerkungen: |
Date Revised 13.02.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.4103/tjem.tjem_134_23 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368336670 |
|---|
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| 245 | 1 | 0 | |a Role of high-dose methylprednisolone in Zargar Grade IIB corrosive esophageal burns |b A randomized control study |
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| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright: © 2024 Turkish Journal of Emergency Medicine. | ||
| 520 | |a OBJECTIVE: The objective of the study is to test the efficacy of high-dose methylprednisolone in the prevention of esophageal stricture after corrosive ingestion | ||
| 520 | |a METHODS: This study was a single-center, randomized controlled single-blinded study. Simple randomization was done with 15 adult patients (>18 years) in each arm, who presented with a history of corrosive ingestion within the past 24 h and had esophageal injury of Zargar Grade IIB on endoscopy. Intravenous methylprednisolone 1 g/day for 3 days was given to the intervention arm while 100 mL of normal saline was given as placebo in control arm. Follow-up to diagnose esophageal stricture was done at 8 weeks | ||
| 520 | |a RESULTS: Thirty patients (15 in each arm) were recruited for the study. As per the intention to treat analysis, 33% and 46.6% developed stricture in the intervention and control arm, respectively (relative risk [RR] = 0.714; 95% confidence interval 0.29-1.75; P = 0.462). 40% patients in control group and 7.7% in intervention group had undergone feeding jejunostomy, which was statistically significant with a p-value of 0.048. Airway injury showed significant clinical improvement in the intervention arm but the difference was nonsignificant statistically (P = 0.674). There was no increased incidence of hypertension, hyperglycemia, hyponatremia, hyperkalemia, or infections in intervention arm | ||
| 520 | |a CONCLUSION: Methylprednisolone does not help in the prevention of stricture formation in corrosive esophageal injury, but it significantly reduces the requirement of feeding jejunostomy and has a beneficial role in treating airway injury | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Airway injury | |
| 650 | 4 | |a Zargar classification | |
| 650 | 4 | |a corrosive ingestion | |
| 650 | 4 | |a esophageal burns | |
| 650 | 4 | |a steroids | |
| 650 | 4 | |a stricture | |
| 700 | 1 | |a Jamshed, Nayer |e verfasserin |4 aut | |
| 700 | 1 | |a Neseem, Akhil |e verfasserin |4 aut | |
| 700 | 1 | |a Aggarwal, Praveen |e verfasserin |4 aut | |
| 700 | 1 | |a Kedia, Saurabh |e verfasserin |4 aut | |
| 700 | 1 | |a Khan, Maroof Ahmad |e verfasserin |4 aut | |
| 700 | 1 | |a Das, Chandan J |e verfasserin |4 aut | |
| 700 | 1 | |a Sahu, Ankit Kumar |e verfasserin |4 aut | |
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