From November 1, 1982 through December 31, 1985, there were 19 centers and 382 patients that evaluated the effect of methylprednisolone sodium succinate (MPSS) on the septic syndrome. Seventeen of these centers enrolled 304 patients in a prospective, randomized, double-blind, placebo-controlled study to determine if early treatment with MPSS would decrease the incidence of severity of the adult...

Acute respiratory distress syndrome (ARDS) remains challenging to diagnose and manage. This article reviews the new definition of ARDS and the key findings of landmark studies over the last 5 years of prone-position ventilation, high-frequency oscillatory ventilation (HFOV), extracorporeal membrane oxygenation (ECMO), and neuromuscular blockade in patients with ARDS.

OBJECTIVES To report the clinical features and prognosis of drug-associatedacute respiratory distress syndrome (ARDS). DESIGN A retrospective analysis of data collected during a prospective cohort study. SETTING Intensive care unit in a teaching hospital. PARTICIPANTS A total of 197 Japanese patients with ARDS diagnosed by the Berlin definition who were admitted to the Division of Respira...

Background: Endothelial injury is an important prognostic factor in acute respiratory distress syndrome (ARDS). Vascular endothelial growth factor (VEGF) plays a critical role in endothelial destruction and angiogenesis. Genetic variations of the VEGF gene have been associated with VEGF production. A study was undertaken to investigate the impact of VEGF gene polymorphisms on the clinical outco...

Acute Respiratory Distress Syndrome (ARDS) is a severe lung illness characterized by inflammation and fluid accumulation in the respiratory system. Historically, ARDS and other forms of respiratory failure have been treated using mechanical ventilation to help maintain gas exchange in the lungs. However, clinical investigators are beginning to discover the adverse effects of mechanical ventilat...

Acute respiratory distress syndrome (ARDS) due to sepsis has a high mortality rate with limited treatment options. High density lipoprotein (HDL) exerts innate protective effects in systemic inflammation. However, its role in ARDS has not been well studied. Peptides such as L-4F mimic the secondary structural features and functions of apolipoprotein (apo)A-I, the major protein component of HDL....

Fifty-nine patients in septic shock were observed for the development of the adult respiratory distress syndrome (ARDS) prior to and after receiving either 30 mg/kg methylprednisolone sodium succinate, 6 mg/kg dexamethasone sodium phosphate or no steroid. Serum levels of C3, C4 and Factor B allowed classification of 42 patients by activation of complement pathways. Despite a trend toward patien...

The use of neuromuscular blocking agents (NMBAs) early in the development of ARDS has been a strategy of interest for many years. The use of NMBAs with a concomitant deep sedation strategy can increase oxygenation and possibly decrease mortality when used in the early stages of ARDS. The mechanism by which this occurs is unclear but probably involves a combination of factors, such as improving ...

To the Editor:—The recent article by Thille et al. and the accompanying editorial by Rouby discuss the effects of positive end-expiratory pressure (PEEP) on pulmonary recruitability in patients with adult respiratory distress syndrome (ARDS). Thille et al. found that alveolar recruitment was similar in pulmonary and extrapulmonary ARDS and concluded that PEEP levels should not be determined bas...