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Báo cáo y học: "Steroid treatment for persistent ARDS: a word of caution"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Steroid treatment for persistent ARDS: a word of caution. | Available online http ccforum.eom content 11 6 425 Letter Steroid treatment for persistent ARDS a word of caution B Taylor Thompson1 Marek Ancukiewicz1 Leonard D Hudson2 Kenneth P Steinberg2 and Gordon R Bernard3 1 Massachusetts General Hospital Boston USA 2University of Washington Seattle USA 3Vanderbilt University Nashville USA Corresponding author B Taylor Thompson tthompson1@partners.org Published 12 December 2007 This article is online at http ccforum.com content 11 6 425 2007 BioMed Central Ltd Critical Care 2007 11 425 doi 10.1186 cc6186 See related comments by Meduri et al. http ccforum.com content 11 4 310 comments and related journal club critique by Wajanaponsan et al. http ccforum.com content 11 4 310 Dr Meduri and colleagues in their comment Steroid treatment in ARDS a highly effective treatment 1 written in response to the article of Wajanaponsan et al. 2 described data and an adjusted analysis provided by the Acute Respiratory Distress Syndrome ARDS Network as a personal communication . We wish to comment on their assertion of large imbalances between the treatment and steroid arms in the cohort of participants randomized after 13 days of ARDS and suggest a word of caution for interpreting this post hoc analysis. Among our small subset of 48 patients randomized after 13 days of ARDS only one of 43 baseline variables was statistically imbalanced between control and methylprednisolone MPS 3 . Partial pressure of arterial oxygen fraction of inspired oxygen P F ratios were similar 126 versus 128 control versus MPS . Mean age 45.2 versus 52.5 and Acute Physiology and Chronic Health Evaluation APACHE III 79 versus 87 were higher in the MPS group but the differences were well within the range of random variation. When adjusted for multiple comparisons there were no statistical differences between two treatment arms. Moreover the lung injury score LIS was missing in over a third of patients and was based on compliance and P F ratio only. We apologize for not