Har glukokortikoider gunstig effekt i behandlingen av sen/fibroproliferativ fase av ARDS?

Abstract

ABSRACT

Title Does use of glucocorticoids have a beneficial effect in treatment of the late/fibroproliferative phase of Acute Respiratory Distress Syndrome (ARDS)?

Background ARDS is a condition presenting with tachypnea, hypoxia and respiratory failure due to direct or indirect injury of the lung. The injury causes an inflammatory response which, for those who survive, may lead to severe lung fibrosis. In Norway there are about 600 cases of ARDS each year, and the mortality rate is over 40%. The objective of this project was to examine the effect of glucocorticoids in the treatment of patients with late phase/fibroproliferative ARDS with regard to mortality.

Methods This project is based on scientific studies obtained through the international medical search engine PubMed by using MeSH-terms as search words. Searches have also been performed in The Cochrane Library to get meta-analyses.

Results Despite varying results in the medical literature, there are no current evidences supporting the use of glucocorticoids in the treatment of late/fibroproliferative phase of ARDS. In fact, onset of therapy with glucocorticoids later than 14 day from diagnosis, is associated with an increased mortality. However, glucocorticoids seem to improve Lung Injury Score (LIS) and Multiple Organ Dysfunction Syndrome (MODS) score. One of the interesting topics, which has not been studied, is whether there are any beneficial long term effects of glucocorticoids in those who survive ARDS. To conclude on this aspect of ARDS, further studies are needed.