Deshpande Kedar S, Appel David W, Camacho Margarita T, Tanaka Kathryn E, Kvetan Vladimir
Division of Critical Care, Department of Medicine, Montefiore Medical Center for the Albert Einstein College of Medicine, Bronx, New York, USA.
Ann Thorac Surg. 2005 Feb;79(2):713-5. doi: 10.1016/j.athoracsur.2003.07.020.
The etiology of acute respiratory distress syndrome is wide and mortality is extremely high. We describe a patient dying from severe acute respiratory distress syndrome who had a tremendous recovery after receiving dexamethasone (1 g daily). This patient required positive end-expiratory pressure (up to 18 mm/Hg) and fractional inspiratory oxygen (up to 100%). Thirty-six hours after the large dose of corticosteroids, the respiratory mechanics and oxygenation were acceptable for extubation. Acute respiratory distress syndrome was proven and other etiologies of respiratory failure were ruled out by a bedside open-lung biopsy. The biopsy proven acute respiratory distress syndrome dramatically resolved with this salvage therapy. High-dose usage of corticosteroids for acute respiratory distress syndrome has tremendous potential.
急性呼吸窘迫综合征的病因广泛，死亡率极高。我们描述了一名因严重急性呼吸窘迫综合征而濒死的患者，在接受地塞米松（每日1克）治疗后病情大幅好转。该患者需要呼气末正压通气（高达18毫米汞柱）和吸入氧分数（高达100%）。大剂量使用皮质类固醇36小时后，呼吸力学和氧合状况达到可进行拔管的程度。经床旁开胸肺活检证实为急性呼吸窘迫综合征，并排除了呼吸衰竭的其他病因。活检证实的急性呼吸窘迫综合征通过这种挽救疗法得到显著缓解。大剂量使用皮质类固醇治疗急性呼吸窘迫综合征具有巨大潜力。
