Sinha Sharmili, Patnaik Rohit, Behera Srikant
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.
World J Crit Care Med. 2024 Jun 9;13(2):91225. doi: 10.5492/wjccm.v13.i2.91225.
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.
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。