LaSRS Study Synopsis
The Efficacy of Corticosteroids as Rescue Therapy for the Late Phase of Acute Respiratory Distress Syndrome
The late phase of ARDS is often characterized by excessive fibroproliferation leading to gas exchange and compliance abnormalities. While corticosteroids are not effective in early ARDS, several case reports and uncontrolled case series and one small randomized, controlled trial suggest that corticosteroids may be useful in the management of late-phase ARDS. To test this hypothesis, a randomized, double-blinded trial comparing corticosteroids to placebo in severe, late-phase ARDS after seven days was conducted. The objective was to determine if the administration of corticosteroids, in the form of methylprednisolone sodium succinate, in severe late-phase ARDS, would reduce mortality and morbidity. In addition, bronchoalveolar lavage and serum were collected during the first week of the study to search for inflammatory markers of fibroproliferation. The study enrolled 180 subjects. The study was completed in November of 2003 and a manuscript describing the results has been submitted for publication.