Efficacy and Safety of Corticosteroids for Persistent Acute Respiratory Distress Syndrome

Abstract

Objective: The aim of this study is to determine the efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. Study Design: Randomized Control Trial Place and Duration: The study was conducted at the emergency department of Lady Reading hospital Peshawar for the duration of six months during the period July to December 2020. Methods: Total 150 patients suffering from acute respiratory distress syndrome were presented in this study. Patients were aged between 40-75 years. Patients’ detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients were equally divided into-2 groups. Group I received corticosteroids and group II received placebo for 7-days of duration. At 28th day efficacy among both groups were assessed and compared in terms of low mortality, free from ventilator and reduction in complications. Complete data was analyzed by SPSS 24.0 version. Results: There were 120 males (60 in each group) and 30 (15 in each group) were females. Mean age of the patients in group I was 59.14±6.45 years with mean BMI 25.88±3.42 kg/m2 and in group II mean age was 58.38±7.46 years with mean BMI 26.41±3.54 kg/m2.Smoking was the most common cause of ARDS, in group I among 40 (53.3%) patients and 42 (56%), followed by chronic lung disease 20 (26.7%) in group I and 19 (25.3%) in group II. After regular follow up, mortality rate among patients of group II was greater 18 (24%) as compared to steroids group 13 (17.3%) and frequency of ventilator free patients were higher among steroids group 39 (52%) as compared to placebo 31 (41.3%). We found that complications reduction in steroids group was greater with minimum recurrence rate. Conclusion: We concluded in this study that the use of corticosteroids for persistent acute respiratory distress syndrome was effective and reliable in terms of low mortality and shorten the time of ventilation. Except this reduction in complications with minimum recurrence rate was found among patients those received steroids. Keywords: Acute respiratory distress syndrome, Placebo, Corticosteroids, Efficacy, Ventilator