Abstract:

Previous studies have shown that low-dose and long-term corticosteroid therapy is associated with good clinical outcomes in patients with acute respiratory distress syndrome (ARDS). However, there is no study investigating the effectiveness of corticosteroids according to ARDS types. The aim of our study is to compare the clinical parameters and in-hospital outcomes of pulmonary and extrapulmonary ARDS patients who treated with corticosteroids in addition to conventional treatments. Between January 2008 and December 2012, the data of 22 patients, who were followed in intensive care unit, were diagnosed with ARDS and underwent low-dose and long-term methylprednisolone treatment, were retrospectively investigated. Patients were divided into two groups as pulmonary ARDS (14 patients) and extrapulmonary ARDS (8 patients). There was no significant difference between pulmonary ARDS and extrapulmonary ARDS groups in terms of age, gender, weight, length of stay in intensive care unit, day ARDS development, and duration of mechanical ventilation (MV). However, the weaning from MV and in hospital survival rate was significantly lower in extrapulmonary ARDS group. In multivariate analysis, extrapulmonary ARDS was detected as an independent predictor of in-hospital mortality. In conclusion, although previous studies have shown an increased survival rate in ARDS patients who received methylprednisolone therapy, it was found that survival rate was lower in extrapulmonary origin ARDS compared to pulmonary origin ARDS in our study. Therefore, it is concluded that more detailed studies are required to demonstrate the benefit of corticosteroids in extrapulmonary ARDS cases.

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