Glucocorticoid Treatment in Acute Lung Injury and Acute Respiratory Distress Syndrome

被引：76

作者：

Marik, Paul E. ^{[1
]}

Meduri, G. Umberto ^{[2
,3
]}

Rocco, Patricia R. M. ^{[4
]}

Annane, Djillali ^{[5
]}

机构：

[1] Eastern Virginia Med Sch, Dept Med, Div Pulm & Crit Care Med, Norfolk, VA 23501 USA

[2] Univ Tennessee, Ctr Hlth Sci, Dept Med, Div Pulm Crit Care & Sleep Med, Memphis, TN 38163 USA

[3] Memphis Vet Affairs Med Ctr, Memphis, TN USA

[4] Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil

[5] Univ Versailles SQY UniverSud Paris, Gen Intens Care Unit, Garches, France

来源：

CRITICAL CARE CLINICS | 2011年 / 27卷 / 03期

关键词：

Acute respiratory distress syndrome; Glucocorticoid; Intensive care unit; Mechanical ventilation; Secondary prevention; Systemic inflammation; COMMUNITY-ACQUIRED PNEUMONIA; CORTICOSTEROID RESCUE TREATMENT; LOW-DOSE HYDROCORTISONE; SEPTIC SHOCK; SYSTEMIC INFLAMMATION; PULMONARY-FIBROSIS; STEROID-THERAPY; SHORT-TERM; METHYLPREDNISOLONE THERAPY; PERSISTENT ELEVATION;

D O I：

10.1016/j.ccc.2011.05.007

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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.

引用

页码：589 / +

页数：20

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