类固醇类型对急性呼吸窘迫综合征患者预后的影响。

IF 3.8 2区 医学 Q1 CRITICAL CARE MEDICINE
Shodai Yoshihro, Shunsuke Taito, Tomoaki Yatabe
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引用次数: 0

摘要

背景:最近的系统综述和荟萃分析表明,低剂量类固醇治疗急性呼吸窘迫综合征(ARDS)是有效的。最近的指南建议使用低剂量类固醇而不是高剂量类固醇。这些系统评价是基于类固醇的作用是恒定的,无论其类型。我们讨论类固醇的使用类型是否会影响ARDS患者的预后。正文:从药理学的角度来看,甲基强的松龙作为一种矿物皮质激素的活性很小,可能导致肺动脉高压。我们之前的网络荟萃分析的秩概率结果显示,就无呼吸机天数而言,与使用其他类型的类固醇或不使用类固醇相比,低剂量甲基强的松龙可能是一种最佳治疗方法。同样,对四项随机对照试验的个体数据分析表明,低剂量甲基强的松龙与ARDS患者死亡率降低相关。地塞米松作为ARDS的一种新型辅助治疗方法引起了临床医生的关注。结论:最近的证据表明,低剂量甲基强的松龙可能是ARDS的有效治疗选择。低剂量甲基强的松龙治疗的开始时间和持续时间应在未来的研究中验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The influence of steroid type on outcomes in patients with acute respiratory distress syndrome.

The influence of steroid type on outcomes in patients with acute respiratory distress syndrome.

Background: Recent systematic reviews and meta-analyses have suggested that low-dose steroids are effective in the treatment of acute respiratory distress syndrome (ARDS). Recent guidelines recommend the use of low-dose steroids instead of high-dose steroids. These systematic reviews were conducted based on the concept that the effect of steroids is constant regardless of their type. We discuss whether the type of steroid used influences the outcomes in patients with ARDS.

Main body: From a pharmacological standpoint, methylprednisolone has little activity as a mineralocorticoid and may cause pulmonary hypertension. The results of the rank probability of our previous network meta-analysis revealed that low-dose methylprednisolone might be an optimal treatment compared to using other types of steroids or no steroids in terms of ventilator-free days. Similarly, an analysis of individual data from four randomized controlled trials suggested that low-dose methylprednisolone was associated with decreased mortality in patients with ARDS. Dexamethasone has attracted the attention of clinicians as a novel adjunct therapy for ARDS.

Conclusion: Recent evidence has shown that low-dose methylprednisolone may be an effective treatment option for ARDS. The timing of initiation and duration of low-dose methylprednisolone therapy should be verified in future studies.

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来源期刊
Journal of Intensive Care
Journal of Intensive Care Medicine-Critical Care and Intensive Care Medicine
CiteScore
11.90
自引率
1.40%
发文量
51
审稿时长
15 weeks
期刊介绍: "Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction. Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.
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