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[Shock lung (ARDS): glucocorticoids?].

H W Möllmann, J Barth, E W Schmidt

    Anasthesie, Intensivtherapie, Notfallmedizin
    |June 1, 1984
    PubMed
    Summary
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    High-dose glucocorticoids may improve survival in acute respiratory distress syndrome (ARDS). Early treatment and standardized high dosages are crucial for effectiveness, but ARDS definition needs refinement.

    Area of Science:

    • Pulmonology
    • Critical Care Medicine
    • Pharmacology

    Background:

    • Acute Respiratory Distress Syndrome (ARDS) is a severe lung condition.
    • Glucocorticoids show promise in mitigating ARDS by improving pulmonary perfusion and reducing inflammation.
    • Existing clinical studies suggest early, high-dose glucocorticoid therapy improves survival rates in ARDS patients.

    Purpose of the Study:

    • To evaluate the efficacy of high-dose glucocorticoid therapy in ARDS.
    • To highlight the need for standardized treatment protocols and clearer diagnostic criteria for ARDS.

    Main Methods:

    • Review of experimental and clinical investigations on glucocorticoid use in ARDS.
    • Analysis of varying dosage regimens and their impact on patient outcomes.

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  • Discussion of pharmacokinetic principles guiding glucocorticoid administration.

    • Main Results:

    • Glucocorticoids increase pulmonary perfusion and stabilize membranes by blocking vasoactive substances.
    • They inhibit neutrophilic chemotaxis and pulmonary leukostasis, reducing inflammation and lung damage.
    • Clinical studies indicate higher survival rates with early, high-dose glucocorticoid treatment.

    Conclusions:

    • High-dose glucocorticoids can be beneficial in ARDS, particularly when administered early.
    • Standardization of ARDS definition, treatment onset, and glucocorticoid dosage regimens is necessary for definitive conclusions.
    • Further research with precise protocols is required to optimize glucocorticoid therapy for ARDS.