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Corticosteroid Treatment in Unresolving ARDS

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Molecular Biology of Acute Lung Injury

Part of the book series: Molecular and Cellular Biology of Critical Care Medicine ((MCCM,volume 1))

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Abstract

Acute respiratory distress syndrome (ARDS) is a severe form of acute lung injury, having a multi-factorial etiology characterized by rapid development of severe diffuse and non-homogenous inflammation of the pulmonary lobules leading to life-threatening hypoxemic respiratory failure. We have tested a therapeutic intervention on a previously defined pathophysiological model of ARDS (1). The model was defined by investigating during the longitudinal course of ARDS, the relationship among the three fundamental elements of a disease process: pathogenesis, structural alterations, and functional consequences (2). In these studies, we provided biological and morphological evidence indicating that ARDS patients failing to improve after one week of mechanical ventilation (unresolving ARDS) have intense and protracted pulmonary and systemic inflammatory and neo-fibrogenetic activity. In a controlled study, prolonged methylprednisolone (MP) treatment in patients with unresolving ARDS was associated with a significant reduction in (a) laboratory indices of inflammation and fibrogenesis, (b) physiological severity of ARDS, and (c) mortality. Our findings indicate that the failure of older trials investigating massive doses of MP in early ARDS was attributable to the short duration of administration.

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Author information

Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, University of Tennessee Health Science Center, USA

    G. Umberto Meduri

  2. The Memphis Lung Research Program, USA

    G. Umberto Meduri

  3. Baptist Memorial Hospitals, USA

    G. Umberto Meduri

Authors
  1. G. Umberto Meduri
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Editor information

Editors and Affiliations

  1. Division of Critical Care Medicine, Children’s Hospital Medical Center and Children’s Hospital Research Foundation, Cincinnati, Ohio, USA

    Hector R. Wong  & Thomas P. Shanley  & 

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© 2001 Springer Science+Business Media New York

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Meduri, G.U. (2001). Corticosteroid Treatment in Unresolving ARDS. In: Wong, H.R., Shanley, T.P. (eds) Molecular Biology of Acute Lung Injury. Molecular and Cellular Biology of Critical Care Medicine, vol 1. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1427-5_16

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  • DOI: https://doi.org/10.1007/978-1-4615-1427-5_16

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5548-9

  • Online ISBN: 978-1-4615-1427-5

  • eBook Packages: Springer Book Archive

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