title: Glucocorticoid treatment in acute lung injury and acute respiratory distress syndrome.
abstract: 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.
authors: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Eastern Virginia Medical School, Norfolk, VA, USA. MarikPE@EVMS.EDU
authors: Paul E
authors: PE
authors: Marik
authors: G Umberto
authors: GU
authors: Meduri
authors: Patricia R M
authors: PR
authors: Rocco
authors: Djillali
authors: D
authors: Annane
mesh_terms: D055371:Acute Lung Injury / Q000150:complications / Q000188:drug therapy*; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy*; D011014:Pneumonia / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids