1967;2:319–23.Horita N, Hashimoto S, Miyazawa N, Fujita H, Kojima R, Inoue M, Ueda A, Ishigatsubo Y, Kaneko T. Impact of corticosteroids on mortality in patients with acute respiratory distress syndrome: a systematic review and meta-analysis.
N Engl J Med. Am J Respir Crit Care Med. You can also search for this author in First, all the trials published before 2005 evaluated the use of steroids in patients treated with nonprotective MV [It should be emphasized that since no studies have been performed to date examining the potential beneficial effects of dexamethasone in ARDS, we only can speculate about the potential limitations of the study. Non-St-Segment Elevation Acute Coronary Syndromes; Atrial Fibrillation; Adult Congenital Heart Disease Multiple organ system failure and infection in adult respiratory distress syndrome. Part of
JV, JB, JMA, JB, DM, JAS, CF, AA, TM, RR, RC, FJDD, MS, MAGB, RLF, LPM, and RMK contributed to the final study design, participated in its coordination, and drafted the manuscript. You can also search for this author in
We postulated that adjunctive treatment of persistent ARDS with intravenous dexamethasone might change the pulmonary and systemic inflammatory response and thereby reduce morbidity, leading to a decrease in duration of mechanical ventilation and a decrease in mortality.This is a prospective, multicenter, randomized, controlled trial in 314 patients with persistent moderate/severe ARDS.
Crit Care Med.
1998;280:159–65.Steinberg KP, Hudson LD, Goodman RB, Hough CL, Lanken PN, Hyzy R, Thompson BT, Ancukiewicz M, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Clinical findings and effects of corticosteroids. Search
Crit Care Med. Third, our study design will not allow us to conclude whether a different dosage would have different effects.
1987;317:1565–70.Hooper RG, Kearl RA. You can also search for this author in
The fibroproliferative response in acute respiratory distress syndrome: mechanisms and clinical significance.
Fibroproliferative phase of ARDS.
2007;125:237–41.de Gans J, van de Beek D, European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators. 2002;30:1772–7.Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Dexamethasone and length of hospital stay in patients with community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial. Am J Respir Crit Care Med. Organization of the Writing Committee e702 3.
Lancet.
2016;42(5):829–40.JV, LPM, RLF have full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.JV and RMK contributed to the initial study concept and design. Variables normally distributed will be compared with the Student’s The steering committee is constituted by the study principal investigators who contributed to its design and approved the final protocol (Planning and conducting the study: designing the protocol, case report forms, designing the investigator manual, and managing and controlling the data quality.Research center support: assisting the centers with the administrative submission, monitoring recruitment rates, providing sealed randomization envelopes, taking actions to increase patient enrollment, monitoring follow-up, auditing, and sending study materials to the research centers.Programming a research-in-progress meeting every 6 months with principal investigators from all sites.Statistical analysis and research reporting: interim and complete statistical analysis and helping in writing the final manuscript.This is the first randomized controlled trial designed to evaluate the efficacy of dexamethasone in patients with persistent ARDS and managed with a protective ventilatory strategy, which includes the use of low VCorticosteroids have been the most widely used medications for ARDS since the first clinical description of the syndrome [There are major differences between our study and other randomized controlled trials evaluating the impact of corticosteroids in patients with ARDS.
COVID-19 is an emerging, rapidly evolving situation.
1994;149(3 Part 1):818–24.ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS. Persistent ARDS is defined as maintaining a PaOThis study will be the largest randomized controlled clinical trial to assess the role of dexamethasone in patients with persistent ARDS.Registered on 21 November 2012 as DEXA-ARDS at ClinicalTrials.gov website (The acute respiratory distress syndrome (ARDS) is an inflammatory disease process of the lungs as a response to both direct and indirect insults, characterized clinically by severe hypoxemia, reduced lung compliance, and bilateral radiographic infiltrates [Corticoids seemed to be an ideal therapy for the acute lung injury in ARDS, given their potent anti-inflammatory and antifibrotic properties [Despite these disappointing trial results, great interest remains in the use of corticosteroids for the salvage of ARDS patients in the early phase of their disease process, a situation that has not been evaluated in most published trials. Curr Opin Crit Care.
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