{"id":517,"date":"2020-09-04T11:03:32","date_gmt":"2020-09-04T11:03:32","guid":{"rendered":"https:\/\/nclinnovations.org\/covid19monitor\/?p=517"},"modified":"2020-09-04T11:03:32","modified_gmt":"2020-09-04T11:03:32","slug":"03-sep-2020-dexamethasone-statistically-significant-increase-in-the-number-of-ventilator-free-days","status":"publish","type":"post","link":"https:\/\/nclinnovations.org\/covid19monitor\/03-sep-2020-dexamethasone-statistically-significant-increase-in-the-number-of-ventilator-free-days\/","title":{"rendered":"(03 Sep 2020) Dexamethasone- statistically significant increase in the number of ventilator-free days"},"content":{"rendered":"<div class=\"boldgrid-section\">\n<div class=\"container\">\n<div class=\"row\">\n<div class=\"col-md-12 col-xs-12 col-sm-12\">\n<p>Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial<\/p>\n<p class=\"\">https:\/\/doi.org\/10.1001\/jama.2020.17021<\/p>\n<p class=\"\">A multicenter, randomized, open-label, clinical trial (NCT04327401) was conducted in 41 intensive care units (ICUs) in Brazil.&nbsp; The trial was stopped early following publication of a related study before reaching the planned sample size of 350 patients. Interventions: Twenty mg of dexamethasone intravenously daily for 5 days, 10 mg of dexamethasone daily for 5 days or until ICU discharge, plus standard care (n =151) or standard care alone (n = 148). A total of 299 patients (mean [SD] age, 61 [14] years; 37% women) were enrolled and all completed follow-up. Patients randomized to the dexamethasone group had a mean 6.6 ventilator-free days (95% CI, 5.0-8.2) during the first 28 days vs 4.0 ventilator-free days (95% CI, 2.9-5.4) in the standard care group (difference, 2.26; 95% CI, 0.2-4.38; P = .04). At 7 days, patients in the dexamethasone group had a mean SOFA score of 6.1 (95% CI, 5.5-6.7) vs 7.5 (95% CI, 6.9-8.1) in the standard care group (difference, -1.16; 95% CI, -1.94 to -0.38; P = .004). There was no significant difference in the prespecified secondary outcomes of all-cause mortality at 28 days, ICU-free days during the first 28 days, mechanical ventilation duration at 28 days, or the 6-point ordinal scale at 15 days. Thirty-three patients (21.9%) in the dexamethasone group vs 43 (29.1%) in the standard care group experienced secondary infections, 47 (31.1%) vs 42 (28.3%) needed insulin for glucose control, and 5 (3.3%) vs 9 (6.1%) experienced other serious adverse events. Among patients with COVID-19 and moderate or severe ARDS, use of intravenous dexamethasone plus standard care compared with standard care alone resulted in a statistically significant increase in the number of ventilator-free days (days alive and free of mechanical ventilation) over 28 days.&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial https:\/\/doi.org\/10.1001\/jama.2020.17021 A multicenter, randomized, open-label, clinical trial (NCT04327401) was conducted in 41 intensive care units&hellip; <span class=\"read-more-span\"><a href=\"https:\/\/nclinnovations.org\/covid19monitor\/03-sep-2020-dexamethasone-statistically-significant-increase-in-the-number-of-ventilator-free-days\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;(03 Sep 2020) Dexamethasone- statistically significant increase in the number of ventilator-free days&#8221;<\/span> <span class=\"genericon genericon-next\"><\/span><\/a><\/span><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"bgseo_title":"","bgseo_description":"","bgseo_robots_index":"index","bgseo_robots_follow":"follow"},"categories":[81,4],"tags":[68],"_links":{"self":[{"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/posts\/517"}],"collection":[{"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/comments?post=517"}],"version-history":[{"count":1,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/posts\/517\/revisions"}],"predecessor-version":[{"id":518,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/posts\/517\/revisions\/518"}],"wp:attachment":[{"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/media?parent=517"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/categories?post=517"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nclinnovations.org\/covid19monitor\/wp-json\/wp\/v2\/tags?post=517"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}