TY - JOUR T1 - Potential Effects of Corticosteroids on Physiological Dead-Space Fraction in Acute Respiratory Distress Syndrome JF - Respiratory Care SP - 377 LP - 383 DO - 10.4187/respcare.01301 VL - 57 IS - 3 AU - Joan M Raurich AU - Mireia Ferreruela AU - Juan A Llompart-Pou AU - Margalida Vilar AU - Asunción Colomar AU - Ignacio Ayestarán AU - Jon Pérez-Bárcena AU - Jordi Ibáñez Y1 - 2012/03/01 UR - http://rc.rcjournal.com/content/57/3/377.abstract N2 - BACKGROUND: Increased dead-space fraction is common in patients with persistent acute respiratory distress syndrome (ARDS). We evaluated the changes in the oxygenation and dead-space fraction in patients with persistent ARDS after corticosteroid therapy. METHODS: This was a non-randomized non-placebo, controlled observational study including 19 patients with persistent ARDS treated with corticosteroids. We measured PaO2/FIO2 and dead-space fraction at days 0, 4, and 7 after corticosteroids treatment (methylprednisolone) initiation. Patients were classified in intermediate group when corticosteroids were initiated between days 8–14 after ARDS onset, and in late group when initiated after 14 days. RESULTS: Mean time from the diagnosis of the ARDS to methylprednisolone treatment was 11 ± 2 days in the intermediate group (10 patients) and 21 ± 8 days in the late group (9 patients). When comparing days 0, 4, and 7 after methylprednisolone treatment, we found an increase in the PaO2/FIO2 (145 ± 64 mm Hg, 190 ± 68 mm Hg, and 226 ± 84 mm Hg, respectively, P < .001) and a decrease in the physiological dead-space fraction (0.66 ± 0.10, 0.58 ± 0.12, and 0.53 ± 0.11, respectively, P < .001). No differences were found between the intermediate and late groups. CONCLUSIONS: In patients with persistent ARDS, the increase in oxygenation was accompanied by a decrease in the dead-space fraction after a few days of corticosteroid treatment. To confirm potential benefit of corticosteroids on physiological parameters and mortality will require a powered randomized placebo controlled trial. ER -