El tratamiento con glucocorticoides en pacientes con síndrome de dificultad respiratoria aguda. Una revisión sistemática de la literatura y metaanálisis

Giraldo Ramírez, Nelson Darío; Vélez, Augusto Quevedo; Posada Uribe, Lord Larry; Rodríguez Quijano, César Augusto
April 2013
Iatreia;abr-jun2013, Vol. 26 Issue 2, p160
Academic Journal
Background: The Acute Respiratory Distress Syndrome (ARDS) is a lung inflammation secondary to primary or extrinsic pulmonary pathology. It is a common disease in the intensive care unit and its mortality rate is high. Objectives: To determine the efficacy and safety of corticosteroids in patients with ARDS older than 18 years, in terms of mortality, mechanical ventilationfree days, and safety in regard to nosocomial infections, health-care related pneumonia, neuromiopathy, and gastrointestinal bleeding. Search methods: A systematic search of electronic and manual literature was done, without restriction of language, of controlled clinical trials involving adults with ARDS, randomized to placebo vs. steroids, and that measured the outcomes described. Results: Seven clinical trials were found showing a decrease in hospital mortality (OR 0.56 [0.38-0.81], 3.5 more days free from mechanical ventilation, a decrease in nosocomial infections and in hospitalacquired pneumonia. There were no differences in the presentation of steroid-associated neuromiopathy. There was a non-significant tendency to increase in bleeding from the digestive tract. Conclusion: Low-dose steroids seem to have a beneficial effect on mortality and ventilator-free days in adult patients with ARDS with no increase in adverse effects.


Related Articles

  • Lifetime risk of suicide in people with schizophrenia lower than commonly reported. Haw, Camilla M. // Evidence Based Mental Health;Nov2005, Vol. 8 Issue 4, p96 

    This article presents a study which focuses on lifetime risk of suicide in people with schizophrenia. Using meta-analysis combining case fatality and proportionate mortality rate data, the estimated lifetime risk of suicide for first admission and new-onset cases of schizophrenia is 5.6%. The...

  • Pressure and Volume Limited Ventilation for the Ventilatory Management of Patients with Acute Lung Injury: A Systematic Review and Meta-Analysis. Burns, Karen E. A.; Adhikari, Neill K. J.; Slutsky, Arthur S.; Guyatt, Gordon H.; Villar, Jesus; Haibo Zhang; Qi Zhou; Cook, Deborah J.; Stewart, Thomas E.; Meade, Maureen O. // PLoS ONE;2011, Vol. 6 Issue 1, p1 

    Background: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are life threatening clinical conditions seen in critically ill patients with diverse underlying illnesses. Lung injury may be perpetuated by ventilation strategies that do not limit lung volumes and airway...

  • Mortality trends in Philadelphia: age- and cause- specific death rates 1870-1930. Condran, Gretchen A.; Cheney, Rose A.; Condran, G A; Cheney, R A // Demography;Feb1982, Vol. 19 Issue 1, p97 

    This article examines the decline in mortality which occurred in Philadelphia in the late nineteenth and early twentieth centuries. Age- and cause-specific mortality rates accounting for the decline are isolated and the relative importance of several variables in explaining the reduction of...

  • Are cohort mortality rates autocorrelated? Foster, Andrew; Foster, A // Demography;Nov1991, Vol. 28 Issue 4, p619 

    In this paper the author examines the proposition that heterogeneity in individual frailty leads to autocorrelation in cohort mortality rates. A simple model is used to construct analytic expressions for the covariance of cohort mortality rates at different ages under a number of alternative...

  • Increases in Age-Group--Specific Injury Mortality -- United States, 1999-2004. Paulozzi, L.; Crosby, A.; Ryan, G. // MMWR: Morbidity & Mortality Weekly Report;12/14/2007, Vol. 56 Issue 49, p1281 

    The article summarizes the results of a report on the age-group-specific injury mortality rates in the U.S. from 1999-2004. It reveals that among persons aged 20-29 years, the total injury mortality rate increased 7.7%, including a 92.5% increase in the death rate from unintentional poisoning...

  • MORTALITY IN AFRICA: AN INTRODUCTORY OVERVIEW. de Carvalho, Ana Pires // Africana Studia;2007, Issue 10, p155 

    The article reports on the mortality rate in Sub-Saharan Africa. It states that mortality is a basic component for the assessment and understanding of the wellbeing of a society and contributes to the understanding of a country's demographics. The author notes that the mortality levels in...

  • Croatia is a safe tourist destination - study of foreign citizen mortality in Splitsko-dalmatinska and Primorsko-goranska County during the period 2001-2010. Becić, Kristijan; Jandrić Becić, Darija; Cengija, ČMorana; Curić, Goran; Alujević, Antonio; Definis-Gojanović, Marija // Croatian Medical Journal;Jun2013, Vol. 54 Issue 3, p291 

    Aim To investigate the mortality rate of foreign citizens in Croatia. Methods Data were collected from the Departments for Forensic Pathology in Split and Rijeka, which are the autopsy centers of the counties with approximately 35% of total foreign visitors, as well as from the Croatian Central...

  • Mortality from Crohn's no better than in 1970s. Baines, Emma // GP: General Practitioner;3/25/2005, p13 

    The article informs that current treatments for Crohn's disease are no better at cutting mortality than treatments used in the 1970s, according to research presented at the conference. Leicester General Hospital researchers carried out a meta-analysis of studies published since 1970 which looked...

  • Poverty and infant mortality in the Eastern Mediterranean region: a meta-analysis. Jahan, S. // Journal of Epidemiology & Community Health;Aug2008, Vol. 62 Issue 8, p745 

    Objectives: To test the hypothesis that poverty is associated with infant mortality in Eastern Mediterranean countries and to measure the strength of the association. Methods: A bibliographic search was conducted. The studies including data regarding deaths during the first year of life,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics