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Critical care clinics · Jul 2011
ReviewGlucocorticoid treatment in acute lung injury and acute respiratory distress syndrome.
- Patricia R M Rocco, Djillali Annane, and G Umberto Meduri.
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Eastern Virginia Medical School, Norfolk, VA, USA. MarikPE@EVMS.EDU
- Crit Care Clin. 2011 Jul 1;27(3):589-607.
AbstractExperimental 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.Copyright © 2011 Elsevier Inc. All rights reserved.
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