Prophylactic Granulocyte Colony-Stimulating Factor in the Intensive Care Unit: It's Safe, But Does It Work?

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SYNOPSIS: Filgrastim (granulocyte colony-stimulating factor [G-CSF]) was given as daily injections of 75 μg or 300 μg versus placebo in a randomized fashion to 61 patients with acute severe traumatic brain injury or intracranial hemorrhage, requiring mechanical ventilation, for 10 days. There was a dose-dependent increase in absolute neutrophil count, and patients receiving G-CSF had a lower incidence of primary bacteremia but no difference in rates of nosocomial pneumonia or urinary tract infections. Similarly, there was no effect on length of stay in the intensive care unit (ICU) or mortality, and adverse effects were similar in placebo and treatment groups.

SOURCE: Heard SO et al. Effect of prophylactic administration of recombinant human granulocyte colony-stimulating factor (filgrastim) on the frequency of nosocomial infections in patients with acute traumatic brain injury or cerebral hemorrhage. Crit Care Med 1998;26:748–54.

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