Pharmacologic Treatments for Acute Respiratory Distress Syndrome

Qadir, Nida; Chang, Steven Y.

doi:10.1016/j.ccc.2021.05.009

Cited by 15 publications

(7 citation statements)

References 94 publications

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“…The activation of inflammatory processes and the involvement of inflammatory factors further promote the development of ARDS [ 21 ]. At present, the mortality rate of ARDS is still high, and timely and effective treatment measures can improve the prognosis of patients [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Effect of Glucocorticoids on Adult Acute Respiratory Distress Syndrome

Chen

Lin

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objectives. The aim of this study is to investigate the effect of glucocorticoids in adult patients with acute respiratory distress syndrome (ARDS) by meta-analysis. Methods. PubMed, Cochrane Library, Embase, CNKI, Wanfang Database, and Chinese Biomedical literature database were searched. A randomized controlled trial (RCTS) on glucocorticoid therapy in adult patients with ARDS was conducted from the time of database construction to December 2021. The content is about the randomized controlled trial (RCT) of glucocorticoid treatment for adult patients with ARDS, without limiting the dose and course of glucocorticoid treatment. The quality of the included RCTS was evaluated by using the bias risk assessment tool of the Cochrane Collaboration network, and the basic information, clinical features, and target outcomes of the literature were extracted. The effects of glucocorticoids on mortality and oxygenation index (PaO2/FiO2) in adult ARDS patients were evaluated by meta-analysis. Results. A total of 1,441 ARDS patients in 10 RCTs were finally included, including 734 patients in the glucocorticoid treatment group (hormone group) and 707 patients in the conventional treatment group (control group). The 10 studies included have a good overall design and high quality. Compared with controls, glucocorticoid use was significantly associated with a decrease in mortality in adult ARDS patients (relative risk (RR) = 0.73, 95% confidence interval (95% CI) = 0.59–0.90, P = 0.003 ). Analysis showed that glucocorticoids significantly reduced the mortality in ARDS patients treated with medium and low doses of steroids (RR = 0.73, 95% CI = 0.58–0.92, P = 0.007 ). In patients with early administration of steroids, intervention with glucocorticoids was significantly associated with the decreased mortality in adult ARDS patients compared with controls (RR = 0.74, 95% CI 0.56–0.99, P = 0.04 ). Among patients with more than 7 days of hormone therapy, treatment with glucocorticoids was significantly associated with decreased mortality in adult ARDS patients (RR = 0.66, 95% CI = 0.50–0.88, P = 0.005 ) compared with controls. Glucocorticoids tended to improve PaO2/FiO2 in adult ARDS patients compared with controls, but the difference was not statistically significant (weighted mean difference (WMD) = 11.60, 95% = CI = 15.02–38.22, P = 0.39 ). Conclusion. Glucocorticoid therapy can reduce mortality in adult ARDS patients, and the benefit is more pronounced in patients with medium- and low-dose hormone therapy, early hormone administration, and hormone therapy for more than 7 days. However, no improvement in PaO2/FiO2 by glucocorticoid treatment was found, which needs to be confirmed by further studies.

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Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Effect of Glucocorticoids on Adult Acute Respiratory Distress Syndrome

Chen

Lin

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Recently, two reviews summarized pharmacological treatments for patients suffering from ARDS [ 232 , 233 ]. Although, the main message of both reviews is that there is no appropriate pharmacological therapy option, but only supportive care, they agree on the necessity to subgroup ARDS patients to identify personalized treatment concepts.…”

Section: Discussionmentioning

confidence: 99%

Antioxidants as Therapeutic Agents in Acute Respiratory Distress Syndrome (ARDS) Treatment—From Mice to Men

et al. 2022

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Acute respiratory distress syndrome (ARDS) is a major cause of patient mortality in intensive care units (ICUs) worldwide. Considering that no causative treatment but only symptomatic care is available, it is obvious that there is a high unmet medical need for a new therapeutic concept. One reason for a missing etiologic therapy strategy is the multifactorial origin of ARDS, which leads to a large heterogeneity of patients. This review summarizes the various kinds of ARDS onset with a special focus on the role of reactive oxygen species (ROS), which are generally linked to ARDS development and progression. Taking a closer look at the data which already have been established in mouse models, this review finally proposes the translation of these results on successful antioxidant use in a personalized approach to the ICU patient as a potential adjuvant to standard ARDS treatment.

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“…Although research on ARDS has been conducted for decades, no effective treatment has been found yet. Supportive care measures based on respiratory support are still used in clinical practice [ 59 ]. This is also true for high-altitude ARDS.…”

Section: Treatmentmentioning

confidence: 99%

Understanding Acute Respiratory Distress Syndrome in High-Altitude Environments: A Comprehensive Review of Diagnosis and Treatment

Guo

Sun

et al. 2023

Med Sci Monit

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Approximately 2% of the global population lives above 1500 m, where low atmospheric pressure, decreased oxygen levels, harsh cold and dry conditions, strong radiation, and the effects of climate change present significant health challenges. Residents of these high-altitude areas display physiological adaptions, including smaller body size, enlarged ribs, improved oxygen delivery in hypoxic conditions, and adjustments in oxygen utilization and metabolism. Both acute and chronic hypoxia prevalent in such regions can trigger various diseases by stimulating hypoxia-inducible factors, boosting inflammatory responses, and impairing mitochondrial function. Acute Respiratory Distress Syndrome (ARDS) – a critical respiratory condition associated with high morbidity and mortality – occurs more frequently among the health risks in these environments. Hypoxia is a critical predisposing and aggravating factor for high-altitude ARDS. Despite similarities with its low-altitude counterpart, ARDS in high-altitude areas displays unique pathophysiology and clinical manifestations due to the specific environmental conditions. This review aims to shed light on how high-altitude environments influence the diagnosis and treatment of ARDS, providing a comprehensive understanding of the distinct challenges inherent to these regions.

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Pharmacologic Treatments for Acute Respiratory Distress Syndrome

Cited by 15 publications

References 94 publications

Meta-Analysis of the Effect of Glucocorticoids on Adult Acute Respiratory Distress Syndrome

Meta-Analysis of the Effect of Glucocorticoids on Adult Acute Respiratory Distress Syndrome

Antioxidants as Therapeutic Agents in Acute Respiratory Distress Syndrome (ARDS) Treatment—From Mice to Men

Understanding Acute Respiratory Distress Syndrome in High-Altitude Environments: A Comprehensive Review of Diagnosis and Treatment

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