Early corticosteroid treatment for postoperative acute lung injury after lung cancer surgery

摘要

Background: Acute lung injury (ALI) is the most serious pulmonary complication after lungresection. Although the beneficial effects of low-dose corticosteroids have been demonstratedin patients with postoperative ALI, there are limited data on optimal corticosteroid treatment.Methods: We retrospectively analyzed 58 patients who were diagnosed with ALI among 7593patients who underwent lung cancer surgery between January 2009 and December 2016.Results: Of the 58 patients, 42 (72%) received corticosteroid treatment within 72 h (earlytreatment group) and 16 (28%) received corticosteroid treatment more than 72 h after ALIoccurred (late treatment group). The early treatment group demonstrated a higher responseto corticosteroid treatment compared with the late treatment group (95% versus 69%,respectively, p = 0.014), had an improved lung injury score (86% versus 63%, p = 0.072), andwere more likely to be successfully weaned from the ventilator within 7 days (57% versus 39%,p = 0.332). During corticosteroid treatment, the early treatment group had a lower rate ofdelirium (24% versus 63%, p = 0.012) compared with the late treatment group. No significantdifferences in length of stay (30 versus 37 days, p = 0.254) or in-hospital mortality (43% versus38%, p = 0.773) were observed; however, the early treatment group tended to have a higherrate of successful weaning than the late treatment group (p = 0.098, log-rank test).Conclusions: Early initiation of corticosteroid treatment improved lung injury and promotedventilator weaning in patients with ALI following lung resection for lung cancer.