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Glucocorticoid Treatment in Acute Respiratory Distress Syndrome: Friend or Foe?

  • P. Pelosi
  • P. R. M. Rocco
Conference paper

Abstract

In the early phases of acute respiratory distress syndrome (ARDS) the evolution of systemic and pulmonary inflammation during mechanical ventilation determines the physiological progression (resolving or unresolving) and outcome of the disease [1, 2, 3]. In order to achieve partial or total resolution of ARDS, an innate or treatment-induced downregulation of systemic inflammation may be required [1]. Glucocorticoids, as end-effectors of the hypothalamic-pituitary-adrenal (HPA) axis, are the most important physiologic inhibitors of inflammation [4] affecting genes involved in stress-related homeostasis [5]. Recent studies have shown that systemic inflammation-induced glucocorticoid receptor resistance and/or insensitivity is an acquired, generalized process central to the pathogenesis of unresolving ARDS that is potentially reversed by quantitatively adequate and prolonged glucocorticoid supplementation [1, 2, 6]. This chapter will review the mechanisms of action of corticosteroids and the results of experimental and clinical studies on the use of corticosteroids in ARDS.

Keywords

Glucocorticoid Receptor Acute Lung Injury Acute Respiratory Distress Syndrome Acquire Immune Deficiency Syndrome Respir Crit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • P. Pelosi
    • 1
  • P. R. M. Rocco
    • 2
  1. 1.Department of AnesthesiologyOspedlae di Circolo e Fondazione MacchiVareseItaly
  2. 2.Laboratory of Pulmonary InvestigationCarlos Chagas Filho Biophysics Institute Federal UniversityRio de JaneiroBrazil

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