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Updated: Jul 23, 2025

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
Severe acute respiratory distress syndrome caused by Otsujito
Nobuhisa Hirasawa1, Hajime Nakae1, Kasumi Satoh1
1Department of Emergency and Critical Care Medicine Akita University Graduate School of Medicine Akita Japan.
Background:
Kampo prescriptions can cause drug-induced lung injury (DLI) and acute respiratory distress syndrome (ARDS). However, severe respiratory failure induced by Otsujito (OJT) is extremely rare. High-dose steroid pulse therapy is generally given to patients with severe DLI.
Case Presentation:
A 63-year-old man with respiratory distress was admitted to our hospital. The patient was diagnosed with severe ARDS caused by OJT, which had been prescribed 4 weeks prior to admission. Thus, OJT was discontinued, and intensive care for ARDS, including ventilation and prone positioning, was implemented. His respiratory condition rapidly improved after treatment with an initial methylprednisolone dose (1.5 mg/kg/day). He was extubated on day 4 and discharged on day 16. The steroid dose was gradually reduced and discontinued by day 116.
Conclusion:
A severe case of ARDS caused by OJT was successfully treated with low-dose steroids and specialized intensive care.
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