Glucocorticoids in the treatment of acute respiratory distress syndrome: pros and cons. Literature review
Keywords:acute respiratory distress syndrome, glucocorticoids, review
Mortality due to acute respiratory distress syndrome remains high despite the introduction of modern mechanical ventilation technologies and extracorporeal membrane oxygenation methods. This is explained mostly by the dysregulated inflammatory response of the organism to the stress factor and the progressive damage of the alveolar-capillary membrane and, as a consequence, the critical reduction of gas exchange in the lungs. Glucocorticoids are among the powerful anti-inflammatory drugs that explains the motivation of clinicians to administer these agents to the patients with severe respiratory distress syndrome. The literature review analyzes the scientific findings that support the efficacy and deny the benefits of glucocorticoids in acute respiratory distress syndrome. According to scientific data, glucocorticoids can be effective if they are used in the early stages of the disease (first 5–7 days) and in low doses with prolonged administration. As for the choice of patients, we may consider those with moderate to severe and severe respiratory distress syndrome (PaO2/FiO2 < 200) who had a progressive decrease in oxygenation despite the use of an adequate mechanical ventilation strategy.
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