Yonsei Med J.  2015 Jan;56(1):287-291. 10.3349/ymj.2015.56.1.287.

Predictors of Response to Corticosteroid Treatment in Patients with Early Acute Respiratory Distress Syndrome: Results of a Pilot Study

• Jeon K
• Chung CR
• Yang JH
• Park CM
• Suh GY

• KMID: 2352818
• DOI: http://doi.org/10.3349/ymj.2015.56.1.287

Abstract

Prospective observational cohort study was performed to evaluate predictors for responsiveness to corticosteroid treatment in patients with acute respiratory distress syndrome (ARDS). Over the study period, a total of 20 patients (male 70%, median age 69) with ARDS were treated with corticosteroid within 72 h after intubation. The median lung injury score (LIS) and partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratios (PF ratios) were 3.0 (interquartile range, 2.7-3.0) and 146.6 (119.9-179.4), respectively. The median levels of triggering receptor expressed on myeloid cells (TREM-1) and procollagen peptide type III in bronchoalveolar lavage (BAL) fluid were 349.3 (225.6-634.9) pg/mL and 19.6 (11.7-39.7) pg/mL, respectively. After 7 days of corticosteroid treatment, 10 (50%) patients showed response to the treatment (successful extubation in 7 and 1-point or more reduction in LIS in 3). Compared to non-responders, responders had higher initial PF ratios (170.5 vs. 127.2, p=0.023), lower level of TREM-1 in BAL fluid (313.6 pg/mL vs. 520.5 pg/mL, p=0.029), and greater reduction in LIS at 3 days (-1 vs. 0, p<0.001). In conclusion, PF ratios and TREM-1 level in BAL fluid at baseline, and reduction in LIS at day 3 after the treatment were associated with the response to prolonged corticosteroid treatment (ClinicalTrials.gov Identifier: NCT01093287).

Keyword

Acute respiratory distress syndrome; glucocorticoids; risk factors; organ dysfunction scores

MeSH Terms

Adrenal Cortex Hormones/*therapeutic use
Aged
Female
Humans
Male
Middle Aged
Pilot Projects
Respiratory Distress Syndrome, Adult/*drug therapy
Treatment Outcome
Adrenal Cortex Hormones

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