Comparison of the Effects of Corticosteroid Therapy on Pulmonary and Extrapulmonary ARDS Patients
Medeniyet Medical Journal
Previous studies have shown that low-dose and long-term corticosteroid therapy is associated with good clinical outcomes in patients with acute respiratory distress syndrome (ARDS). However, there is no study investigating the efficacy of corticosteroids in these patients according to ARDS types. The aim of our study is to compare the clinical parameters and in-hospital outcomes of pulmonary and extrapulmonary ARDS patients who were treated with corticosteroids in addition to conventional
... ents. The data of 22 patients, who were followed up in intensive care unit, diagnosed as ARDS and underwent low-dose and long-term methylprednisolone treatment between January 2008 and December 2012 were retrospectively investigated. Patients were divided into two main groups as pulmonary ARDS (14 patients) and extrapulmonary ARDS (8 patients), and comparisons were made. There was no significant difference between pulmonary ARDS and extrapulmonary ARDS groups in terms of age, gender, weight, length of stay in intensive care unit, onset day of ARDS development, and duration of mechanical ventilation (MV). However, the weaning from MV and in-hospital survival rate was significantly lower in extrapulmonary ARDS group. In multivariate analysis, extrapulmonary ARDS was detected as an independent predictor of in-hospital mortality. In conclusion, although previous studies have shown an increased survival rate in ARDS patients who received methylprednisolone therapy, in our study it was found that survival rate was lower in extrapulmonary ARDS compared to pulmonary ARDS. Therefore, it is concluded that more detailed studies are required to demonstrate the benefit of corticosteroids in the treatment of extrapulmonary cases of ARDS.