Steroid Therapy for Acute Respiratory Distress Syndrome in Nonseptic Lobectomy Patients
Clinical Pulmonary Medicine, 05/02/2012
Langenfeld J et al. – Nonseptic patients with Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) identified by CT scan and given steroids early in the course of ARDS after surgery demonstrated a rapid recovery, which is considerably better than historical data.Methods
- A total of 625 lobectomies were performed between August 1999 and January 2010.
- Eleven patients developed ARDS and 2 developed ALI.
- Symptoms developed an average of 3.2days (1 to 5d) after surgery.
- Early chest x-ray findings showed only nonspecific infiltrative process that started in the lung contralateral to the side of resection.
- Computed tomography (CT) scans demonstrated diffuse ground-glass opacities that were not recognized by chest x-rays.
- The response to this steroid regimen was rapid with a significant improvement occurring in the PaO2/FiO2 ratio within 24hours.
- There were no mortalities.
- The average time on a ventilator was 1.5days and the average hospital length of stay was 11days.
- A CT scan and a high degree of clinical awareness are essential in making an early diagnosis of ARDS/ALI after a lobectomy.