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Tidsskr Nor Laegeforen. 2001 May 20;121(13):1596-8.

[Steroid treatment of shock lung--tune for re-evaluation?].

[Article in Norwegian]

Author information

1
Intensivavdelingen, UllevÄl sykehus, 0407 Oslo. yngvar.gundersen@ffi.no

Abstract

BACKGROUND:

The acute respiratory distress syndrome (ARDS) is one consequence of the body's systemic inflammatory response to a variety of powerful external stimuli. Glucocorticosteroids are highly effective anti-inflammatory drugs. During the last few years, the molecular mechanisms for their mode of action have been revealed; this has prompted a new wave of interest in corticosteroid treatment of systemic inflammatory states. Several clinical studies have been launched; the results have so far been promising.

MATERIAL AND METHODS:

We briefly discuss how new knowledge in this field may influence the use of corticosteroids in the treatment of ARDS. The presentation is illustrated by a case study.

RESULTS:

The patient was a 15-year-old boy with life-threatening and therapy-resistant ARDS. He was treated in a respirator in an intensive care unit (ICU). Two weeks after admission to the ICU, his situation was desperate. High-dose corticosteroids were instituted, and during a five days' treatment his condition improved dramatically. After discontinuation of glucocorticoids he made further progress and was discharged from the ICU after another eleven days.

INTERPRETATION:

In this particular patient, administration of glucocorticoids had a striking effect. The influence of glucocorticoids on the activation of the transcription factor NF-kappa B and a resulting reduced synthesis of a number of key inflammatory molecules may be one explanation for the positive course.

PMID:
11446045
[Indexed for MEDLINE]
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