Evidence of biological efficacy for prolonged corticosteroid treatment in unresolving acute respiratory distress syndrome

摘要

Acute respiratory distress syndrome (ARDS) is a disease of multi-factorial etiology characterized by rapid development of severe diffuse and non-homogenous inflammation of the pulmonary lobules, causing life-threatening hypo-xemic respiratory failure. We have tested a therapeutic intervention on a previously defined pathophysiological model of ARDS [1]. The model was defined by investigating during the longitudinal course of ARDS, the relationship among the three fundamental elements of a disease process pathogenesis, structural alterations, and functional consequences [2]. In these studies, we provided biological and morphological evidence indicating that ARDS patients failing to improve after 1 week of mechanical ventilation (unresolving ARDS) have intense and protracted pulmonary and systemic inflammatory and neo-fi-brogenetic activity.