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In a recent clinical trial, moderate-dose corticosteroids were not beneficial for patients with acute respiratory distress syndrome (ARDS; Journal Watch Apr 21 2006). However, a subgroup analysis suggested possible benefit when steroids were started within 7 to 13 days of onset of ARDS (as opposed to starting after day 13). This U.S. trial from Memphis examined outcomes when steroids are started early and given for several weeks.
Ninety-one patients with severe early ARDS were randomized within 72 hours of intubation to receive either IV methylprednisolone (1 mg/kg daily) or placebo. The methylprednisolone dose was tapered over 28 days. By day 7, a lung injury score was significantly lower in the steroid group than in the placebo group, and …