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Subject Area

Family Medicine

Article Type

Original Study

Abstract

Objective The aim of this study wa s to evaluate the effect of methylprednisolone on inflammatory markers including C-reactive protein and interleukin-6 (IL-6) in acute respiratory distress syndrome (ARDS) at an early stage and on patients' outcomes. Background ARDS is started by an inflammatory injury to the lung that results in severe gas exchange impairment and lung compliance abnormalities. Increased levels of bronchoalveolar lavage and blood level of inflammatory biomarkers at ARDS onset are associated with worst prognosis that persists for no less than 7 days. Believing the way that inflammation is the main pathophysiology of ARDS, steroids would be an ideal treatment for the ARDS management. Patients and methods We conducted a randomized prospective observational study included 40 patients with ARDS in the ICU of Menoufia University Hospital who were divided equally into two groups: group I received standard treatment and group II received methylprednisolone beside standard treatment. C-reactive protein and IL-6 levels were measured in serum, and their changes were compared between both the groups. Results The groups were matched by demographic, sequential organ failure assessment, and lung injury score. Methylprednisolone and standard treatment group showed significant decrease in IL-6 level compared with only standard treatment group at day 7 (P < 0.05). Methylprednisolone improved significantly sequential organ failure assessment and lung injury score by seventh day and shortened the mechanical ventilation duration, but it did not improve significantly ICU stay duration and 60-day mortality. Conclusion In the early period of ARDS, administration of methylprednisolone improved significantly biomarkers of inflammation and clinical outcomes.

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