Suppr超能文献

急性呼吸窘迫综合征中的类固醇:是万灵药还是仍为谜题?

Steroids in acute respiratory distress syndrome: A panacea or still a puzzle?

作者信息

Sinha Sharmili, Patnaik Rohit, Behera Srikant

机构信息

Department of Critical Care Medicine, Apollo Hospitals, Bhubaneswar 751005, Odisha, India.

Department of Critical Care Medicine, Medeor 24x7 Hospital, Al Danah 40330, Abu Dhabi, United Arab Emirates.

出版信息

World J Crit Care Med. 2024 Jun 9;13(2):91225. doi: 10.5492/wjccm.v13.i2.91225.

Abstract

Acute respiratory distress syndrome (ARDS) is a unique entity marked by various etiologies and heterogenous pathophysiologies. There remain concerns regarding the efficacy of particular medications for each severity level apart from respiratory support. Among several pharmacotherapies which have been examined in the treatment of ARDS, corticosteroids, in particular, have demonstrated potential for improving the resolution of ARDS. Nevertheless, it is imperative to consider the potential adverse effects of hyperglycemia, susceptibility to hospital-acquired infections, and the development of intensive care unit acquired weakness when administering corticosteroids. Thus far, a multitude of trials spanning several decades have investigated the role of corticosteroids in ARDS. Further stringent trials are necessary to identify particular subgroups before implementing corticosteroids more widely in the treatment of ARDS. This review article provides a concise overview of the most recent evidence regarding the role and impact of corticosteroids in the management of ARDS.

摘要

急性呼吸窘迫综合征(ARDS)是一种具有多种病因和异质性病理生理学特征的独特病症。除呼吸支持外,对于每种严重程度的特定药物疗效仍存在担忧。在几种已用于治疗ARDS的药物疗法中,尤其是皮质类固醇已显示出改善ARDS消退的潜力。然而,在使用皮质类固醇时,必须考虑高血糖、医院获得性感染易感性以及重症监护病房获得性肌无力等潜在不良反应。迄今为止,数十年来众多试验研究了皮质类固醇在ARDS中的作用。在更广泛地将皮质类固醇应用于ARDS治疗之前,需要进一步严格的试验来确定特定亚组。这篇综述文章简要概述了关于皮质类固醇在ARDS管理中的作用和影响的最新证据。

相似文献

1
Steroids in acute respiratory distress syndrome: A panacea or still a puzzle?
World J Crit Care Med. 2024 Jun 9;13(2):91225. doi: 10.5492/wjccm.v13.i2.91225.
3
Role of corticosteroids in the management of acute respiratory distress syndrome.
Clin Ther. 2008 May;30(5):787-99. doi: 10.1016/j.clinthera.2008.05.012.
5
Corticosteroids and ARDS: A review of treatment and prevention evidence.
Lung India. 2011 Apr;28(2):114-9. doi: 10.4103/0970-2113.80324.
6
Corticosteroids in ARDS.
J Clin Med. 2023 May 8;12(9):3340. doi: 10.3390/jcm12093340.
8
What Is the Evidence for Harm of Neuromuscular Blockade and Corticosteroid Use in the Intensive Care Unit?
Semin Respir Crit Care Med. 2016 Feb;37(1):51-6. doi: 10.1055/s-0035-1570355. Epub 2016 Jan 28.
9
2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia.
Crit Care Med. 2024 May 1;52(5):e219-e233. doi: 10.1097/CCM.0000000000006172. Epub 2024 Jan 19.
10
Immunonutrition for acute respiratory distress syndrome (ARDS) in adults.
Cochrane Database Syst Rev. 2019 Jan 24;1(1):CD012041. doi: 10.1002/14651858.CD012041.pub2.

引用本文的文献

1
Pediatric Acute Respiratory Distress Syndrome Updates in the Light of the PALICC-2 Guidelines.
Turk Arch Pediatr. 2025 Jul 1;60(4):362-371. doi: 10.5152/TurkArchPediatr.2025.24331.

本文引用的文献

1
A New Global Definition of Acute Respiratory Distress Syndrome.
Am J Respir Crit Care Med. 2024 Jan 1;209(1):37-47. doi: 10.1164/rccm.202303-0558WS.
2
ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies.
Intensive Care Med. 2023 Jul;49(7):727-759. doi: 10.1007/s00134-023-07050-7. Epub 2023 Jun 16.
3
Hydrocortisone in Severe Community-Acquired Pneumonia.
N Engl J Med. 2023 May 25;388(21):1931-1941. doi: 10.1056/NEJMoa2215145. Epub 2023 Mar 21.
5
Acute respiratory distress syndrome: causes, pathophysiology, and phenotypes.
Lancet. 2022 Oct 1;400(10358):1145-1156. doi: 10.1016/S0140-6736(22)01485-4. Epub 2022 Sep 4.
6
Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia.
Intensive Care Med. 2022 Aug;48(8):1009-1023. doi: 10.1007/s00134-022-06684-3. Epub 2022 May 13.
7
Steroid treatment in patients with acute respiratory distress syndrome: a systematic review and network meta-analysis.
J Anesth. 2022 Feb;36(1):107-121. doi: 10.1007/s00540-021-03016-5. Epub 2021 Nov 10.
9
Utilizing machine learning to improve clinical trial design for acute respiratory distress syndrome.
NPJ Digit Med. 2021 Sep 9;4(1):133. doi: 10.1038/s41746-021-00505-5.
10
Low-dose hydrocortisone in patients with COVID-19 and severe hypoxia: The COVID STEROID randomised, placebo-controlled trial.
Acta Anaesthesiol Scand. 2021 Nov;65(10):1421-1430. doi: 10.1111/aas.13941. Epub 2021 Sep 20.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验