Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
doi:10.1378/chest.07-0927
(Chest. 2007; 132:1094)
© 2007 American College of Chest Physicians
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Zijlstra, J. G.
Right arrow Articles by Ligtenberg, J. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zijlstra, J. G.
Right arrow Articles by Ligtenberg, J. J.

Steroids in Early ARDS

Jan G. Zijlstra, MD and Jack J. Ligtenberg, MD

University Medical Center, Groningen, the Netherlands

Correspondence to: Jack J. Ligtenberg, MD, University Medical Center, PO Box 30001, Groningen, 9700 RB, the Netherlands; e-mail: j.j.m.ligtenberg{at}int.umcg.nl

To the Editor:

We admire the endurance of Dr. Meduri et al1 in completing their ARDS study (April 2007). However, during the 10 years that passed after the start of this study there have been important changes in daily ICU practice. In the control arm, with 46% catecholamine-dependent patients, no steroids were administered in the first week. With the spread of the Surviving Sepsis Campaign,2 most patients in the control arm and probably several in the treatment arm would nowadays have received low-dose steroids (100 to 300 mg/24 h). We wonder how much of the beneficial results of the study are attributable to undertreatment of the control patients. Surprisingly Dr. Annane, one of the advocates of low-dose steroid treatment in septic shock, did not mention this item in the accompanying editorial.3 We can image the enthusiasm for steroids, but the study by Meduri et al1 does not justify the unconditional title of the editorial. Even Dr. Meduri advises a further study with stratification to minimize the risks of mismatching as occurred in this study.

Footnotes

The authors have no conflicts of interest to disclose.

References

  1. Meduri, GU, Golden, E, Freire, AX, et al (2007) Methylprednisolone infusion in early severe ARDS: results of a randomized controlled trial. Chest 131,954-963[Abstract/Free Full Text]
  2. Dellinger, RP, Carlet, JM, Masur, H, et al Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 2004;32,858-873[CrossRef][ISI][Medline]
  3. Annane, D Glucocorticoids for ARDS: just do it! Chest 2007;131,945-946[Free Full Text]




This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Zijlstra, J. G.
Right arrow Articles by Ligtenberg, J. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zijlstra, J. G.
Right arrow Articles by Ligtenberg, J. J.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS