Steroid Intervention in Unresolving ARDS.

The efficacy of methylprednisolone in sustained acute respiratory distress syndrome (ARDS) has been unclear, but positive results in some patient subgroups encouraged investigators to perform a double-blind, placebo-controlled trial of prolonged steroid therapy at four medical centers. The 24 patients who had been on mechanical ventilation for at least seven days without improvement in Lung Injury Score received intravenous or oral methylprednisolone (2 mg/kg/day) or placebo for the first two weeks, with decreased dosages over the following 18 days.

Several parameters of lung function improved during the first 10 days in the 16 patients randomized to oral or IV steroids; no improvement was seen with placebo. On day 10, 44 percent of patients…