Downey Medical Center, Hospitalist Department, Downey, CA, USA.
Perm J. 2022 Apr 5;26(1):106-118. doi: 10.7812/TPP/21.090.
Pulse steroids therapy is widely used to treat flare-ups of autoimmune diseases, such as systemic lupus erythematosus. The main assumption is that severe inflammation caused by an autoimmune disease must be aggressively quelled before it causes further damage. We present a series of 9 cases that explore the use of high-dose pulse steroids in hypoxemic respiratory failure. We used high-dose steroids to alter the outcome of some patients, using commonly accepted protocols such as 6 mg of dexamethasone via IV, baricitinib, and tocilizumab. The outcome of each case is discussed. The patients were treated with 500 mg of high-dose methylprednisolone via IV for 3 days, followed by 250 mg via IV for 3 days; followed by 12 or 6 mg of dexamethasone was administered daily by mouth or IV. A retrospective review of patients who received a computerized tomography pulmonary angiogram showed that these patients had organizing pneumonia features. Eight out of nine cases had a favorable outcome.
脉冲类固醇疗法被广泛用于治疗自身免疫性疾病的发作,如系统性红斑狼疮。主要假设是,自身免疫性疾病引起的严重炎症必须在其造成进一步损害之前积极抑制。我们提出了一系列 9 例探讨在低氧性呼吸衰竭中使用大剂量脉冲类固醇的情况。我们使用大剂量类固醇来改变一些患者的结果,使用了常用的方案,如静脉注射 6 毫克地塞米松、巴瑞替尼和托珠单抗。讨论了每个病例的结果。患者接受了 500 毫克大剂量甲基强的松龙静脉注射 3 天,然后静脉注射 250 毫克 3 天;然后每天口服或静脉注射 12 或 6 毫克地塞米松。对接受计算机断层肺动脉造影的患者进行回顾性审查显示,这些患者具有机化性肺炎特征。9 例中有 8 例结果良好。