Methylprednisolone infusion in early severe ARDS: results of a randomized controlled trial.
Meduri, G Umberto. Golden, Emmel. Freire, Amado X. Taylor, Edwin. Zaman, Muhammad. Carson, Stephanie J. Gibson, Mary. Umberger, Reba. Chest. 131(4):954-63, 2007 Apr.
Severe early ARDS (≤ 72 h)
A loading dose of 1 mg/kg.
Infusion* 1 mg/kg/d from day 1 to day 14
0.5 mg/kg/d from day 15 to day 21
0.25 mg/kg/d from day 22 to day 25
0.125 mg/kg/d from day 26 to day 28.
If the patient was extubated between days 1 and 14, the patient was advanced today 15 of drug therapy and tapered according to schedule.
If the patient failed to improve LIS (**see definition below) between days 7 and 9, iniciar ttratamiento con (2 mg/kg/d) for unresolving ARDS
* Methylprednisolone was mixed in 240mL of normal saline solution and administered daily as an infusion at 10 mL/h and changed to a single oral dose when enteral intake was restored
**For patients remaining intubated on study day 7, improvement in lung function was defined as follows: (1) a reduction in LIS
≥1 point, and (2) a day 7 LIS ≤ 2.0 (for study entry LIS ≤ 2.9) or ≤ 2.5 (for study entry LIS 3.0)
Experts Indicate Methylprednisolone May Save One in Six Treated Patients