Considered to have sound physiological basis as many of the pathological processes contributing to ARDS Steroids exert an anti-inflammatory effect by inhibiting the arachidonic acid pathway and reducing eosinophil activity Proposed that this effect reduces cytokine...
Early ARDS RCTBernard et al NEJM (1987)View Paper RCTMeduri et al Chest (2005)View Paper RCT: DEXA-ARDSFerrando et al Lancet (2020)View Paper Late ARDS RCTMeduri et al JAMA (1998)View Paper RCTARDSNet NEJM (2006)View Paper Intervention Methylprednisolone vs. placebo...
Sound physiological basis for using inhaled pulmonary vasodilators: Can selectively vasodilate vessels well-ventilated lung units Leads to improved V/Q matching throughout the lungs Reduced PVR and PAP, leading to improved right heart function Related...
Further information available here Drug Inhaled Nitric Oxide (iNO) Nebulised Prostacyclin Nebulised Milrinone Mechanism Activates soluble guanyl cyclase n smooth muscle leading to the conversion of GTP to cGMP resulting in vasodilatation Activates adenyl cyclase in...
A wide variety of medical therapies have been tried in the effort to manage ARDS Ultimately, they remain experimental with no clear benefit demonstrated from those trialled Therapies trialled include: Endogenous surfactant Enteral omega-3 fatty acids / antioxidants...
