Journal
CRITICAL CARE CLINICS
Volume 27, Issue 3, Pages 589-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ccc.2011.05.007
Keywords
Acute respiratory distress syndrome; Glucocorticoid; Intensive care unit; Mechanical ventilation; Secondary prevention; Systemic inflammation
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Experimental and clinical evidence show a strong association between dysregulated systemic inflammation and progression of acute respiratory distress syndrome (ARDS). This article reviews eight controlled studies evaluating corticosteroid treatment initiated before day 14 of ARDS. Available data provide a consistent strong level of evidence for improving outcomes. Treatment was also associated with a markedly reduced risk of death. This low-cost highly effective therapy is well-known, and has a low-risk profile when secondary prevention measures are implemented. The authors recommend prolonged methylprednisolone at 1 mg/kg/d initially in early ARDS, increasing to 2 mg/kg/d after 7 to 9 days of no improvement.
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