A 54-year-old man with severe ARDS has been ventilated for 21 days. CT shows extensive bilateral fibroproliferative changes with traction bronchiectas...

Question

A 54-year-old man with severe ARDS has been ventilated for 21 days. CT shows extensive bilateral fibroproliferative changes with traction bronchiectasis. The team considers whether corticosteroids may benefit late-phase ARDS. The Meduri et al. (2007) trial examined this question. What was the key finding?

Accepted Answer

Low-dose methylprednisolone (1 mg/kg/day) commenced between days 7-14 of unresolving ARDS improved oxygenation, reduced duration of mechanical ventilation, and reduced ICU mortality - but starting after day 14 may be harmful

Answer

Steroids had no effect at any stage of ARDS

Answer

High-dose steroids at any stage improved mortality

Answer

Steroids worsened fibroproliferation

Answer

Only dexamethasone was studied

uk-fficm MCQ (SBA): ARDS - Late-Phase Steroids