title: The effects of dexamethasone and oxygen in ventilated adult sheep with early phase acute respiratory distress syndrome.
abstract: BACKGROUND
  Acute respiratory distress syndrome (ARDS) is a life-threating condition with high morbidity and mortality. Inflammation is the main factor in the pathogenesis of ARDS. Therefore systemic corticosteroids are a rational therapeutic approach, but the effect of corticosteroids is still unclear. In this study, we looked at the effects of corticosteroids in ventilated sheep with ARDS, induced by lung lavage.
  
  
  METHODS
  We performed a prospective, randomised study in 64 ventilated sheep with ARDS, to evaluate the effect of corticosteroids and oxygen concentration on gas exchange and lung injury. Oxygenation index (OI) and ventilation efficacy index (VEI) were calculated to evaluate gas exchange. Lung injury was assessed by inflammatory response in broncho-alveolar lavage fluid (BALF) and plasma and histology of the lung.
  
  
  RESULTS
  OI, VEI, lung inflammation, surfactant production, or lung histology was not influenced by corticosteroids. In the 100 % oxygen groups, OI was higher and total number of cells and disaturated phospholipids were lower in BALF.
  
  
  CONCLUSIONS
  Our study showed that corticosteroids did not influence inflammation in early phase ARDS and that hyperoxia aggravated lung injury which could not be modulated by dexamethasone in early phase ARDS.
authors.affiliation: Department of Paediatrics, School for Oncology and Developmental Biology - GROW, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, PO Box 5800, 6202 AZ, Maastricht, The Netherlands, M.Engel@mumc.nl.
authors.forename: Monique
authors.initials: M
authors.lastname: Engel
authors.forename: Relana M E
authors.initials: RM
authors.lastname: Nowacki
authors.forename: Pim
authors.initials: P
authors.lastname: Boden
authors.forename: Lucy K
authors.initials: LK
authors.lastname: Reiss
authors.forename: Stefan
authors.initials: S
authors.lastname: Uhlig
authors.forename: Niki L
authors.initials: NL
authors.lastname: Reynaert
authors.forename: Poornima
authors.initials: P
authors.lastname: Gopal
authors.forename: Emiel F M
authors.initials: EF
authors.lastname: Wouters
authors.forename: Coen H M P
authors.initials: CH
authors.lastname: Willems
authors.forename: Nico
authors.initials: N
authors.lastname: Kloosterboer
authors.forename: Tim G A M
authors.initials: TG
authors.lastname: Wolfs
authors.forename: Luc J I
authors.initials: LJ
authors.lastname: Zimmermann
authors.forename: Gijs D
authors.initials: GD
authors.lastname: Vos
authors.forename: Boris W
authors.initials: BW
authors.lastname: Kramer
mesh_terms: D055371:Acute Lung Injury / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D000305:Adrenal Cortex Hormones / Q000494:pharmacology* / Q000633:toxicity; D000367:Age Factors; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D003907:Dexamethasone / Q000494:pharmacology* / Q000633:toxicity; D004195:Disease Models, Animal; D005260:Female; D018836:Inflammation Mediators / Q000378:metabolism; D008168:Lung / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects*; D010743:Phospholipids / Q000378:metabolism; D011014:Pneumonia / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D037661:Pulmonary Surfactant-Associated Proteins / Q000378:metabolism; D012121:Respiration, Artificial / Q000009:adverse effects; D012128:Respiratory Distress Syndrome / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D012756:Sheep; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D018836:Inflammation Mediators; D010743:Phospholipids; D037661:Pulmonary Surfactant-Associated Proteins; D003907:Dexamethasone