Effect of Methylprednisolone Treatment in Patients with Early Acute Respiratory Distress Syndrome

Abstract

Objective: Despite the high incidence and poor outcomes of acute respiratory distress syndrome (ARDS), it has no specific treatment. Many pharmacological therapies have been investigated in several studies, but there are limited treatment options with proven efficacy. The aim of our present study was to determine the effect of methylprednisolone treatment on mortality and morbidity rates in early ARDS. Methods: Forty-seven patients with ARDS who underwent mechanical ventilation (MV) between January 2008 and December 2012 were enrolled in this study. They were classified into two groups: methylprednisolone group (22 patients) and control group (25 patients). Those in the methylprednisolone group received a 2-mg/kg intravenous loading dose of methylprednisolone on the first day, followed by an infusion of 0.5 mg/kg every 6 h on days 2-15 and of 0.25 mg/kg every 6 h on days 16-22. Results: The weaning rate from MV was significantly higher (p=0.005), duration of MV was shorter (p=0.021), and mortality rate was lower (p=0.013) in the methylprednisolone group than in the control group. In Kaplan-Meier analysis, survival probabilities in the methylprednisolone group were significantly higher than those in the control group (p=0.022). Furthermore, the lung injury score, multiple organ dysfunction syndrome score, and C-Reactive Protein levels were lower in the methylprednisolone group. However, there were no differences between the two groups in terms of the day ARDS developed, duration of ARDS, and length of stay. Conclusion: Our study showed that early methylprednisolone treatment in patients with ARDS provides significant recovery in pulmonary and extrapulmonary organ function, increases the possibility of weaning from MV, and reduces the mortality rate.