Use of corticosteroids in the adult respiratory distress syndrome: A clinical review

Research output: Contribution to journalArticle

Abstract

Adult respiratory distress syndrome (ARDS) is a major cause of morbidity and mortality in critically ill patients. This form of acute respiratory failure represents a stereotypic response of the lung to many injurious mediators. Adult respiratory distress syndrome is characterized by pulmonary infiltrates, severe hypoxemia, and reduced lung compliance, and expresses clinically as an increased-permeability pulmonary edema. Despite modern treatment modalities, the high mortality rate (>50%) from ARDS has not appreciably decreased over the last 20 years. A major issue of controversy in the therapy of ARDS is the use of corticosteroids (CS) for the prophylaxis and treatment of this syndrome. In this report, current concepts of the pathophysiology of ARDS are discussed, while focusing on potential areas of benefit of CS. Experience with steroids is then reviewed, considering human studies of CS in established ARDS and pulmonary fibrosis, and the prevention of ARDS in high risk patients. After considering available data, it is concluded that the use of CS cannot be recommended for the prevention or therapy of ARDS.

Original languageEnglish (US)
Pages (from-to)241-251
Number of pages11
JournalJournal of Critical Care
Volume5
Issue number4
DOIs
StatePublished - 1990
Externally publishedYes

Fingerprint

Adult Respiratory Distress Syndrome
Adrenal Cortex Hormones
Lung Compliance
Lung
Mortality
Pulmonary Fibrosis
Pulmonary Edema
Therapeutics
Critical Illness
Respiratory Insufficiency
Permeability
Steroids
Morbidity

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Use of corticosteroids in the adult respiratory distress syndrome : A clinical review. / Putterman, Chaim.

In: Journal of Critical Care, Vol. 5, No. 4, 1990, p. 241-251.

Research output: Contribution to journalArticle

@article{9bacaf9987f64752abfd5e2e59bab3ce,
title = "Use of corticosteroids in the adult respiratory distress syndrome: A clinical review",
abstract = "Adult respiratory distress syndrome (ARDS) is a major cause of morbidity and mortality in critically ill patients. This form of acute respiratory failure represents a stereotypic response of the lung to many injurious mediators. Adult respiratory distress syndrome is characterized by pulmonary infiltrates, severe hypoxemia, and reduced lung compliance, and expresses clinically as an increased-permeability pulmonary edema. Despite modern treatment modalities, the high mortality rate (>50{\%}) from ARDS has not appreciably decreased over the last 20 years. A major issue of controversy in the therapy of ARDS is the use of corticosteroids (CS) for the prophylaxis and treatment of this syndrome. In this report, current concepts of the pathophysiology of ARDS are discussed, while focusing on potential areas of benefit of CS. Experience with steroids is then reviewed, considering human studies of CS in established ARDS and pulmonary fibrosis, and the prevention of ARDS in high risk patients. After considering available data, it is concluded that the use of CS cannot be recommended for the prevention or therapy of ARDS.",
author = "Chaim Putterman",
year = "1990",
doi = "10.1016/0883-9441(90)90046-C",
language = "English (US)",
volume = "5",
pages = "241--251",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Elsevier BV",
number = "4",

}

TY - JOUR

T1 - Use of corticosteroids in the adult respiratory distress syndrome

T2 - A clinical review

AU - Putterman, Chaim

PY - 1990

Y1 - 1990

N2 - Adult respiratory distress syndrome (ARDS) is a major cause of morbidity and mortality in critically ill patients. This form of acute respiratory failure represents a stereotypic response of the lung to many injurious mediators. Adult respiratory distress syndrome is characterized by pulmonary infiltrates, severe hypoxemia, and reduced lung compliance, and expresses clinically as an increased-permeability pulmonary edema. Despite modern treatment modalities, the high mortality rate (>50%) from ARDS has not appreciably decreased over the last 20 years. A major issue of controversy in the therapy of ARDS is the use of corticosteroids (CS) for the prophylaxis and treatment of this syndrome. In this report, current concepts of the pathophysiology of ARDS are discussed, while focusing on potential areas of benefit of CS. Experience with steroids is then reviewed, considering human studies of CS in established ARDS and pulmonary fibrosis, and the prevention of ARDS in high risk patients. After considering available data, it is concluded that the use of CS cannot be recommended for the prevention or therapy of ARDS.

AB - Adult respiratory distress syndrome (ARDS) is a major cause of morbidity and mortality in critically ill patients. This form of acute respiratory failure represents a stereotypic response of the lung to many injurious mediators. Adult respiratory distress syndrome is characterized by pulmonary infiltrates, severe hypoxemia, and reduced lung compliance, and expresses clinically as an increased-permeability pulmonary edema. Despite modern treatment modalities, the high mortality rate (>50%) from ARDS has not appreciably decreased over the last 20 years. A major issue of controversy in the therapy of ARDS is the use of corticosteroids (CS) for the prophylaxis and treatment of this syndrome. In this report, current concepts of the pathophysiology of ARDS are discussed, while focusing on potential areas of benefit of CS. Experience with steroids is then reviewed, considering human studies of CS in established ARDS and pulmonary fibrosis, and the prevention of ARDS in high risk patients. After considering available data, it is concluded that the use of CS cannot be recommended for the prevention or therapy of ARDS.

UR - http://www.scopus.com/inward/record.url?scp=0025668456&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025668456&partnerID=8YFLogxK

U2 - 10.1016/0883-9441(90)90046-C

DO - 10.1016/0883-9441(90)90046-C

M3 - Article

AN - SCOPUS:0025668456

VL - 5

SP - 241

EP - 251

JO - Journal of Critical Care

JF - Journal of Critical Care

SN - 0883-9441

IS - 4

ER -