OBJECTIVE: To investigate the safety of the granulocyte colony-stimulating factor filgrastim in the prevention of nosocomial infections in intubated patients in the intensive care unit (ICU), with special emphasis on the possible deleterious effect on acute respiratory distress syndrome (ARDS) and the development of multiple organ dysfunction (MOD). DESIGN: Predetermined, interim analysis of a prospective, randomized, placebo-controlled, double-blind trial. SETTING:University hospital medical-surgical ICU. PATIENTS: A total of 59 consecutive ICU patients, aged >18 yrs, admitted to the ICU no more than 12 hrs before the study, intubated because of ventilatory insufficiency no more than 48 hrs before the study, expected to stay in the ICU for >48 hrs, and had informed consent from the next relative. INTERVENTIONS: Patients were randomized to receive either placebo or 300 microg of filgrastim subcutaneously once daily for 7 days. MEASUREMENTS AND MAIN RESULTS: No significant differences were found in the number of patients developing ARDS (2 of 20 in the placebo group vs. 0 of 22 in the filgrastim group), disseminated intravascular coagulation (3 of 27 vs. 3 of 29), acute renal failure (1 of 27 vs. 1 of 23), or change in MOD. Data analysis showed nosocomial infections in 11 of 29 patients in the placebo group and in 7 of 30 patients in the filgrastim group (p = .266). The median (range) length of ICU stay was 8 (1-34) days in the placebo group and 6 days (1-28) in the filgrastim group. The day 28 mortality rate was 17% (5 of 29) in the placebo group and 13% (4 of 30) in the filgrastim group. No drug-related adverse events occurred. CONCLUSION:Filgrastim is safe in intubated ICU patients, with no excess risk for development of ARDS or MOD.
RCT Entities:
OBJECTIVE: To investigate the safety of the granulocyte colony-stimulating factor filgrastim in the prevention of nosocomial infections in intubated patients in the intensive care unit (ICU), with special emphasis on the possible deleterious effect on acute respiratory distress syndrome (ARDS) and the development of multiple organ dysfunction (MOD). DESIGN: Predetermined, interim analysis of a prospective, randomized, placebo-controlled, double-blind trial. SETTING: University hospital medical-surgical ICU. PATIENTS: A total of 59 consecutive ICU patients, aged >18 yrs, admitted to the ICU no more than 12 hrs before the study, intubated because of ventilatory insufficiency no more than 48 hrs before the study, expected to stay in the ICU for >48 hrs, and had informed consent from the next relative. INTERVENTIONS:Patients were randomized to receive either placebo or 300 microg of filgrastim subcutaneously once daily for 7 days. MEASUREMENTS AND MAIN RESULTS: No significant differences were found in the number of patients developing ARDS (2 of 20 in the placebo group vs. 0 of 22 in the filgrastim group), disseminated intravascular coagulation (3 of 27 vs. 3 of 29), acute renal failure (1 of 27 vs. 1 of 23), or change in MOD. Data analysis showed nosocomial infections in 11 of 29 patients in the placebo group and in 7 of 30 patients in the filgrastim group (p = .266). The median (range) length of ICU stay was 8 (1-34) days in the placebo group and 6 days (1-28) in the filgrastim group. The day 28 mortality rate was 17% (5 of 29) in the placebo group and 13% (4 of 30) in the filgrastim group. No drug-related adverse events occurred. CONCLUSION: Filgrastim is safe in intubated ICU patients, with no excess risk for development of ARDS or MOD.
Authors: Manfred Weiss; Sami Voglic; Britt Harms-Schirra; Ingrid Lorenz; Britta Lasch; Kristoffel Dumon; Wilhelm Gross-Weege; Elisabeth Marion Schneider Journal: Intensive Care Med Date: 2003-04-08 Impact factor: 17.440
Authors: Kun Yang; Elie Azoulay; Lynda Attalah; Jean-Ralph Zahar; Andry Van de Louw; Charles Cerf; Claude-James Soussy; Philippe Duvaldestin; Laurent Brochard; Christian Brun-Buisson; Alain Harf; Christophe Delclaux Journal: Intensive Care Med Date: 2003-01-23 Impact factor: 17.440
Authors: Benjamin T Suratt; Mark D Eisner; Carolyn S Calfee; Jenna B Allard; Laurie A Whittaker; Dustin T Engelken; Joseph M Petty; Thomas Trimarchi; Lauren Gauthier; Polly E Parsons Journal: Crit Care Med Date: 2009-04 Impact factor: 7.598
Authors: Hartmut Schaefer; Andreas Engert; Guido Grass; Georg Mansmann; Gernot Wassmer; Kai Hubel; Dietrich Loehlein; Bernward C Ulrich; Hans Lippert; Wolfram T Knoefel; Arnulf H Hoelscher Journal: Ann Surg Date: 2004-07 Impact factor: 12.969