Effects of glucocorticoids on acute respiratory distress syndrome in adults patients: meta-analysis
10.3760/cma.j.issn.1671-0282.2010.01.023
- VernacularTitle:糖皮质激素对成人急性呼吸窘迫综合征疗效的Meta分析
- Author:
Jiexin WANG
;
Qiongyao HU
;
Chaofeng DING
;
Xiaojun HU
- Publication Type:Journal Article
- Keywords:
Glucocorticoids;
Acute respiratory distress syndrome;
Meta-analysis
- From:
Chinese Journal of Emergency Medicine
2010;19(1):83-88
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To analyze the effect of glucocorticoids on acute respiratory distress syndrome (ARDS) in adult patients. Method English and Chinese literature about the glucocorticoids treatment for ARDS were electronically searched. Meta-analysis was performed by Rev Man 5.0 software after the data of qualified studies were included in consistence with the criteria of inclusion and exclusion. Results Eight studies including 679 cases(steroid group 366, control group 313) met the inclusion criteria. Resuhs of meta-analysis showed that there were significant differences( P <0.05), between the steroid group and the control group, in mortality in all cases, mortality in patients treated at early stage, mortality in patients treated with low dose steroids, and PaO_2/FiO_2;the relative risks(RRs)/standardized mean difference(SMDs) and 95% confidence intervals(CIs) are 0.55(0. 34 ～ 0.87), 0.49(0.28 ～ 0.86), 0.46(0.24 ～ 0.88) and 2.99(0.63 ～ 5.34). There were no significant differences in mortality in patients treated during late stage, mortality in patients treated with high dose steroids and number of nosocomial infections(P > 0.05). Conclusions Low-dose glucocorticoids or routine dose glucocorticoids given during early stage can reduce mortality in patients with ARDS; the oxygenation of patients is significantly improved after steroid therapy; incidence of infectious complications is neither increased nor decreased by steroid therapy.
