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2000, Number 6

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Med Crit 2000; 14 (6)

Late Acute Respiratory Distress Syndrome. A new entity

Carrillo ER

Language: Spanish
References: 68
Page: 203-214
PDF size: 389.04 Kb.


ABSTRACT

Objective: To report our experience with the use of methylprednisolone in the treatment of late ARDS.
Design: Case series report.
Setting: An ICU of tertiary care hospital, Mexico City.
Patients: Six patients (three women, three men, mean age 35.1 yrs) with ARDS.
Interventions: Invasive hemodynamic monitoring, pulmonary biopsies, bronchoscopies, treatment with mechanical ventilation and methylprednisolone.
Measurements and main results: Two patients died. On the 4 th ICU week the following mean values was founded: in responder patients PaO2/FIO2 380, Qs/Qt 5%, Murray index 0 points, pulmonary vascular resistance index 100 din.s/cm-5 cardiac index 3 L/min, compliance 63 cm H2O, diffuse alveolar damage and thrombosis of small lung vessels; and the non responder patients PaO2/FIO2 110, Qs/Qt 43%, Murray index 4 points, pulmonary vascular resistance index 280 din.s/cm-5, cardiac index 4 L/min, compliance 23 cm H2O, extensive fibrosis with complete loss of the alveolar and vascular architecture.
Conclusion: Methylprednisolone may be useful in the treatment of late ARDS.


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