title: [Pharmacological therapies for ARDS].
abstract: Acute respiratory distress syndrome (ARDS) is a noncardiogenic pulmonary edema resulting from increased capillary permeability. Numerous pharmacologic therapies have been studied for prevention and treatment of ARDS. Although several pharmacological therapies could improve patient's respiratory function, there have been no controlled studies which clearly demonstrated the clinical benefit for ARDS-related mortality. The role of corticosteroids in ARDS remains controversial. Available evidence is against early administration of high-dose corticosteroids (methylprednisolon 120 mg x kg-1 x day - 1). In contrast, low-dose corticosteroid therapy (methylprednisolon 0.5-2.5mgg kg-1 xday-1)remains controversial. With regard to sivelestat sodium, a specific inhibitor of neutrophil elastase, although the effectiveness in decreasing mortality was not clarified, increases in lung oxygenation and ventilator-free days have consistently been revealed. Other probable pharmacologic therapies for ARDS include continuous infusion of cisatracurium. In conclusion, there are not established drugs for ARDS, and further studies are necessary to reveal the clinical effectiveness of the above mentioned and novel pharmacologic therapies.
authors.affiliation: Depertment of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo 160-8582.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Izumida
authors.forename: Seitaro
authors.initials: S
authors.lastname: Fujishima
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage*; D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000188:drug therapy; D005998:Glycine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D015201:Meta-Analysis as Topic; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage; D011486:Protein C / Q000008:administration & dosage; D053491:Proteinase Inhibitory Proteins, Secretory / Q000008:administration & dosage*; D020551:Pulse Therapy, Drug; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000008:administration & dosage; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000188:drug therapy*; D013449:Sulfonamides / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D009466:Neuromuscular Blocking Agents; D011486:Protein C; D053491:Proteinase Inhibitory Proteins, Secretory; D011994:Recombinant Proteins; D013449:Sulfonamides; D001279:Atracurium; C069195:sivelestat; C421124:drotrecogin alfa activated; C101584:cisatracurium; D005998:Glycine; D008775:Methylprednisolone