Abstract:
Background: Deficits in the treatment options makes Acute Respiratory Distress Syndrome (ARDS) management more challenging. With Involvement of inflammatory pathways, corticosteroid remains a vital choice for ARDS treatment. However lack of studies and presence of ambiguity in results with use of glucocorticoids makes it imperative to carry out more research. The aim of the study was to assess the efficacy of glucocorticoids in the treatment of ARDS and to identify the treatment pattern of ARDS. Methods: Retrospective observational study, involving 150 patients with confirmed diagnosis of ARDS admitted during January 2011 to December 2011 in a tertiary care hospital. Demographics, social habits, and association between glucocorticoid initiation and respective onset and outcomes like mortality and free ventilator days, were analysed by Chi square test and p<0.05 was considered to be statistically significant. Data analysis was done by using SPSS version 16. Results: Mean age of our study population was 43.37 ± 16.15 with male 60.7% and 39.3% female. The study found reduced mortality (41.7%) in the glucocorticoid treatment group compared to the non-glucocorticoid group (56.4%) (p < 0.022). Among the glucocorticoid treated subgroups, in the early start subgroup there was a statistically significant reduction of mean ventilator days (4.61 ± 2.81 vs 6.44 ± 4.47) and mortality (30.9% vs 80%, p <0.001). Conclusions: The use of glucocorticoids in ARDS showed benefits, especially when started early in the course of treatment with reduced mortality and decreased ventilator days. However small sample size precluded the power of detection of important outcome such as mortality and more research is necessary to establish the role of glucocorticoid therapy in ARDS.
Key words: ARDS, Glucocorticoids, Mortality.