scholarly journals Three cases of low dose hydrocortisone infusion for acute respiratory distress syndrome (ARDS) caused by community-acquired pneumonia

2007 ◽  
Vol 14 (3) ◽  
pp. 315-320 ◽  
Author(s):  
Takamitsu Hamada ◽  
Shinya Nishimura ◽  
Motoko Kimura ◽  
Yoshiya Miyazaki ◽  
Hidenobu Nishihara ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Low Dose ◽  
Distress Syndrome ◽  
Community Acquired Pneumonia

scholarly journals Effect of low-dose exogenous surfactant on infants with acute respiratory distress syndrome after cardiac surgery: A retrospective analysis

2020 ◽  
Author(s):  
Rongyuan Zhang ◽  
Xu Wang ◽  
Shoujun Li ◽  
Jun Yan
Keyword(s):  
Cardiac Surgery ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Standard Therapy ◽  
Low Dose ◽  
Distress Syndrome ◽  
Exogenous Surfactant ◽  
Control Group ◽  
Surfactant Treatment

Abstract Background: To evaluate the effect of low-dose exogenous surfactant therapy on infants suffering acute respiratory distress syndrome (ARDS) after cardiac surgery. Methods: We conducted a retrospective case-control study of infants diagnosed with moderate-severe ARDS after cardiac surgery. A case was defined as a patient that received surfactant and standard therapy, while a control was defined as a patient that underwent standard therapy. The primary endpoint was the improvement in oxygenation index (OI) after 24-hour of surfactant treatment; and secondary endpoints were the ventilator time and PICU time. Results: 22 infants treated with surfactant were matched with 22 controls. Early low-dose (20mg/kg) surfactant treatment was associated with improved outcomes. After surfactant administration for 24-hour, the surfactant group was much better compared with the control group at the 24-hour in OI (difference in average change from baseline, -6.7 [95% CI, -9.3 to -4.1]) (P < 0.01) and VI (mean difference, -11.9 [95% CI, -18.1 to -5.7]) (P < 0.01). Ventilation time and PICU time were significantly shorter in the surfactant group compared with the control group (133.6h±27.2 vs 218.4h±28.7, P < 0.01 ; 10.7d±5.1 vs 17.5d±6.8, P < 0.01). Infants in the surfactant group under 3 months benefit more from OI and VI than the infants over 3 months in a preliminary exploratory analysis.Conclusions: In infants with moderate-severe ARDS after cardiac surgery, early low-dose exogenous surfactant treatment could prominently improve oxygenation and reduce mechanical ventilation time and PICU time. Infants younger than 3 months may get more benefit of oxygenation than the older ones.

Differential Characteristics of Patients With Mild Acute Respiratory Distress Syndrome Due to Community-Acquired Pneumonia Admitted to ICU

CHEST Journal ◽  
2014 ◽  
Vol 145 (3) ◽  
pp. 176A
Author(s):  
Laura Novella ◽  
Francisco Sanz ◽  
Estrella Fernández-Fabrellas ◽  
Ángela Cervera ◽  
Maria Luisa Briones ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Community Acquired Pneumonia

scholarly journals Low-dose CT for quantitative analysis in acute respiratory distress syndrome

2013 ◽  
Author(s):  
Vittoria Vecchi ◽  
Thomas Langer ◽  
Massimo Bellomi ◽  
Cristiano Rampinelli ◽  
Kevin K. Chung ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Quantitative Analysis ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Low Dose ◽  
Distress Syndrome ◽  
Low Dose Ct

scholarly journals Low Dose Radiotherapy to Thorax for COVID 19 Patients: A Potential Weapon to Put the Dagger in Devil's heart

2020 ◽  
Vol 5 (S1) ◽  
pp. 167-169
Author(s):  
Aman Sharma ◽  
Daya Nand Sharma
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Organ Failure ◽  
Low Dose ◽  
Distress Syndrome ◽  
Antiviral Treatment ◽  
Upper Respiratory Tract ◽  
Multi Organ Failure ◽  
Low Dose Radiotherapy

The novel coronavirus SARS-Cov-2/COVID-19 pandemic has emerged as a major healthcare burden to the entire world. At the moment there is no specific antiviral treatment recommended for COVID-19, and no vaccine is currently available. The clinical spectrum of SARS-CoV-2 infection ranges from asymptomatic infection, mild upper respiratory tract illness to severe pneumonia with respiratory failure, multi organ failure and death. The inflammatory response induced in pneumonia is complex and involves a variety of mechanisms to defend against pathogens and repair tissue. During inflammation, activation of inflammatory cells releases cytokines and this intense inflammatory reaction can further to life threatening condition know acute respiratory distress syndrome. In the past, low dose radiotherapy has successfully cured patients with unresolved viral pneumonia. It was associated with reduction of mortality in unresolved pneumonias. Radiotherapy at low doses exerts anti-inflammatory effects which have potential to r duce the cytokine storm in COVID pneumonia patients. We hereby briefly touch upon COVID 19 infection and potential of low dose radiotherapy to reverse unresolved pneumonia, prevent deve opment of acute respiratory distress syndrome as well as multi-organ failure.

scholarly journals Effectiveness and Outcome of Methylprednisolone versus Hydrocortisone in Treatment of Acute Respiratory Distress Syndrome(ARDS)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S A S Elbrassi ◽  
K M Maghawry ◽  
R M M Ali ◽  
R H Abdelhafiez
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Critically Ill ◽  
Low Dose ◽  
Distress Syndrome ◽  
Patient Discharge ◽  
P Value ◽  
D Dimer

Abstract Introduction Acute respiratory distress syndrome (ARDS) is the clinical manifestation of severe acute lung injury. It is characterized by dyspnea, profound hypoxemia, diffuse bilateral infiltrates secondary to non-cardiogenic pulmonary edema on chest radiography, and decreased lung compliance and systemic inflammations are the pathophysiologic hallmarks of this syndrome and the use of low-dose corticosteroids was associated with improved mortality and morbidity outcomes without increased adverse reactions. Aim The aim of this study is to compare the outcome and effectiveness of hydrocortisone to methylprednisolone in treatment of acute respiratory distress syndrome in critically ill adult patients. Patients The current study was performed as a randomized prospective observational study on critically ill patients at age between 18-85 years. Methods Critically ill patients diagnosis with ARDS were managed with standard treatment in addition to methylprednisolone 1mg/kg as loading dose followed by an infusion of 1 mg/kg/d for one week and then gradual tapering over two weeks as following (0.5 mg/kg/d in the second week and 0.25 mg/kg/d in the third week) or hydrocortisone 50mg given every six hours for one week. Results Mean age of included patients was 65.20 years with mean BMI 28.14 kg/m2, in our result the PaO2/FIO2 ratio revealed significant statistically increase in methylprednisolone-treated patients compared to hydrocortisone -treated patients (160.49±54.75, 138.55±60.99, P value 0.029), Regarding the inflammatory marker the results of the plasma level of C-reactive protein and d-dimer showed significant difference between both group, the result of SOFA score showed no significant different from day 1 to day 3 (8.25±3.11, 8.29±2.29 P value 0.980). But with the beginning of the fifth day was observed significant change in the results, methylprednisolone-treated patients compared to hydrocortisone -treated patients (8.28±3.84, 9.8±4.23, P value 0.036), Regarding to ICU length of stay and decrease duration of mechanical ventilation, the results of our study didn’t show significant different among both groups. The two groups showed a decrease in the time spended on the mechanical ventilation and the stay in the ICU before day7. According to the number of patient discharge from ICU at day 7 and the number of extubated patient at day 7, the results of our study didn’t show significant different among both groups. Conclusion Despite the both applied drug doses show improvement regarding the finial total outcome. However, Methylprednisolone showed superior benefit compare to Hydrocortisone in improvement of PaO2/FiO2 ratio, suppress systemic inflammation (CRP and D- dimer), increase extubated patient before day 7, increase number of patient discharge from ICU before day 7, reduction of SOFA score and hospital morality rate. Recommendations The study recommends to use of low dose methylprednisolone superior to hydrocortisone in treatment of ARDS. But, still more researches are need.

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