Rationale for routine and immediate administration of intravenous estrogen for all critically ill and injured patients

Crit Care Med. 2010 Oct;38(10 Suppl):S620-9. doi: 10.1097/CCM.0b013e3181f243a9.

Abstract

In addition to a number of very compelling clinical observations, an extensive body of extremely supportive experimental data has generated a very persuasive argument that intravenous estrogen should be routinely administered, as soon as possible, to all persons identified as having a critical illness or injury. Although, to date, definitive gold-standard clinical trials are lacking, what has made this provocative argument even more convincing is the longstanding, documented safety of intravenous estrogen for various illnesses and conditions as well as the relative ease and inexpensive cost of treatment. As such, even routine prehospital administration becomes extremely feasible for a myriad of conditions. More importantly, the worldwide magnitude of potential patients who could benefit is profound. Even if estrogen only changes the outcome in a relatively small percentage of applicable cases, the potential impact may still be of dramatic proportions in terms of the absolute number of lives saved and the resources spared worldwide. Resources may be spared not only in terms of diminishing the economic impact of death and long-term disability, but also in terms of preventing extended intensive care unit stays and treatment of preventable complications that result in longer recovery.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Brain Injuries / drug therapy
  • Brain Ischemia / drug therapy
  • Critical Care / methods*
  • Critical Illness / therapy
  • Disease Models, Animal
  • Estrogens / administration & dosage
  • Estrogens / pharmacology
  • Estrogens / therapeutic use*
  • Female
  • Heart Arrest / drug therapy
  • Humans
  • Infusions, Intravenous
  • Intracranial Hemorrhages / drug therapy
  • Male
  • Progesterone / therapeutic use
  • Rats
  • Spinal Cord Injuries / drug therapy
  • Testosterone / therapeutic use
  • Treatment Outcome
  • Wounds and Injuries / drug therapy

Substances

  • Estrogens
  • Testosterone
  • Progesterone