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Potential effects of corticosteroids on physiological dead-space fraction in acute respiratory distress syndrome.
Respir Care. 2012 Mar; 57(3):377-83.RC

Abstract

BACKGROUND

Increased dead-space fraction is common in patients with persistent acute respiratory distress syndrome (ARDS). We evaluated the changes in the oxygenation and dead-space fraction in patients with persistent ARDS after corticosteroid therapy.

METHODS

This was a non-randomized non-placebo, controlled observational study including 19 patients with persistent ARDS treated with corticosteroids. We measured P(aO(2))/F(IO(2)) and dead-space fraction at days 0, 4, and 7 after corticosteroids treatment (methylprednisolone) initiation. Patients were classified in intermediate group when corticosteroids were initiated between days 8-14 after ARDS onset, and in late group when initiated after 14 days.

RESULTS

Mean time from the diagnosis of the ARDS to methylprednisolone treatment was 11 ± 2 days in the intermediate group (10 patients) and 21 ± 8 days in the late group (9 patients). When comparing days 0, 4, and 7 after methylprednisolone treatment, we found an increase in the P(aO(2))/F(IO(2)) (145 ± 64 mm Hg, 190 ± 68 mm Hg, and 226 ± 84 mm Hg, respectively, P < .001) and a decrease in the physiological dead-space fraction (0.66 ± 0.10, 0.58 ± 0.12, and 0.53 ± 0.11, respectively, P < .001). No differences were found between the intermediate and late groups.

CONCLUSIONS

In patients with persistent ARDS, the increase in oxygenation was accompanied by a decrease in the dead-space fraction after a few days of corticosteroid treatment. To confirm potential benefit of corticosteroids on physiological parameters and mortality will require a powered randomized placebo controlled trial.

Authors+Show Affiliations

Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain. joan.raurich@ssib.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22004685

Citation

Raurich, Joan M., et al. "Potential Effects of Corticosteroids On Physiological Dead-space Fraction in Acute Respiratory Distress Syndrome." Respiratory Care, vol. 57, no. 3, 2012, pp. 377-83.
Raurich JM, Ferreruela M, Llompart-Pou JA, et al. Potential effects of corticosteroids on physiological dead-space fraction in acute respiratory distress syndrome. Respir Care. 2012;57(3):377-83.
Raurich, J. M., Ferreruela, M., Llompart-Pou, J. A., Vilar, M., Colomar, A., Ayestarán, I., Pérez-Bárcena, J., & Ibáñez, J. (2012). Potential effects of corticosteroids on physiological dead-space fraction in acute respiratory distress syndrome. Respiratory Care, 57(3), 377-83. https://doi.org/10.4187/respcare.01301
Raurich JM, et al. Potential Effects of Corticosteroids On Physiological Dead-space Fraction in Acute Respiratory Distress Syndrome. Respir Care. 2012;57(3):377-83. PubMed PMID: 22004685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potential effects of corticosteroids on physiological dead-space fraction in acute respiratory distress syndrome. AU - Raurich,Joan M, AU - Ferreruela,Mireia, AU - Llompart-Pou,Juan A, AU - Vilar,Margalida, AU - Colomar,Asunción, AU - Ayestarán,Ignacio, AU - Pérez-Bárcena,Jon, AU - Ibáñez,Jordi, Y1 - 2011/10/12/ PY - 2011/10/19/entrez PY - 2011/10/19/pubmed PY - 2012/4/11/medline SP - 377 EP - 83 JF - Respiratory care JO - Respir Care VL - 57 IS - 3 N2 - BACKGROUND: Increased dead-space fraction is common in patients with persistent acute respiratory distress syndrome (ARDS). We evaluated the changes in the oxygenation and dead-space fraction in patients with persistent ARDS after corticosteroid therapy. METHODS: This was a non-randomized non-placebo, controlled observational study including 19 patients with persistent ARDS treated with corticosteroids. We measured P(aO(2))/F(IO(2)) and dead-space fraction at days 0, 4, and 7 after corticosteroids treatment (methylprednisolone) initiation. Patients were classified in intermediate group when corticosteroids were initiated between days 8-14 after ARDS onset, and in late group when initiated after 14 days. RESULTS: Mean time from the diagnosis of the ARDS to methylprednisolone treatment was 11 ± 2 days in the intermediate group (10 patients) and 21 ± 8 days in the late group (9 patients). When comparing days 0, 4, and 7 after methylprednisolone treatment, we found an increase in the P(aO(2))/F(IO(2)) (145 ± 64 mm Hg, 190 ± 68 mm Hg, and 226 ± 84 mm Hg, respectively, P < .001) and a decrease in the physiological dead-space fraction (0.66 ± 0.10, 0.58 ± 0.12, and 0.53 ± 0.11, respectively, P < .001). No differences were found between the intermediate and late groups. CONCLUSIONS: In patients with persistent ARDS, the increase in oxygenation was accompanied by a decrease in the dead-space fraction after a few days of corticosteroid treatment. To confirm potential benefit of corticosteroids on physiological parameters and mortality will require a powered randomized placebo controlled trial. SN - 0020-1324 UR - https://www.unboundmedicine.com/medline/citation/22004685/Potential_effects_of_corticosteroids_on_physiological_dead_space_fraction_in_acute_respiratory_distress_syndrome_ L2 - http://rc.rcjournal.com/cgi/pmidlookup?view=short&amp;pmid=22004685 DB - PRIME DP - Unbound Medicine ER -