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首页> 中文期刊> 《世界急诊医学杂志（英文）》 >Efficacy and safety of low-dose corticosteroids for acute respiratory distress syndrome:A systematic review and meta-analysis

Efficacy and safety of low-dose corticosteroids for acute respiratory distress syndrome:A systematic review and meta-analysis

         
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摘要

BACKGROUND:There are confl icting results regarding whether corticosteroids have better effi cacy than placebo in acute respiratory distress syndrome(ARDS)patients.Therefore,we aim to further evaluate the effi cacy and safety of corticosteroids in adult ARDS patients.METHODS:The databases,including Medline,EMBASE,and Cochrane Central Register of Controlled Trials(CENTRAL)in the Cochrane Library,were searched from their inception to May 2,2020.Randomized controlled trials(RCTs)and observational cohort studies were selected to assess the use of corticosteroids in adult ARDS patients.The quality of the results was judged by the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)methodology.The inverse-variance method with random or fixed effects modeling was used to compute pooled odds ratio(OR),standardized mean diff erence(SMD),and their 95%confi dence interval(CI).RESULTS:Eight eligible RCTs and six cohort studies were included.The use of corticosteroids was associated with reduced mortality(OR 0.57,95%CI 0.43-0.76,I2=35.1%,P=0.148)in ARDS patients,and the result was confirmed in the included cohort studies(OR 0.51,95%CI 0.27-0.95,I2=66.7%,P=0.010).The subgroup analysis stratified by the initiation time and duration of corticosteroid use showed that early ARDS and prolonged corticosteroid use had signifi cant survival benefits in the RCTs.The low-dose corticosteroid use was also associated with significantly more ventilator-free days and a reduced rate of new infections in ARDS patients.CONCLUSIONS:The low-dose corticosteroid therapy may be safe and reduce mortality,especially in patients with prolonged treatment and early ARDS.

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  • 来源
    《世界急诊医学杂志（英文）》 |2021年第003期|207-213|共7页
  • 作者

    Yu-qing Cui; Xian-fei Ding; Huo-yan Liang; Dong Wang; Xiao-juan Zhang; Li-feng Li; Quan-cheng Kan; Le-xin Wang; Tong-wen Sun;

  • 作者单位

    General ICU the First Affiliated Hospital of Zhengzhou University Henan Key Laboratory of Critical Care Medicine Zhengzhou Key Laboratory of Sepsis Henan Engineering Research Center for Critical Care Medicine Zhengzhou 450052 China;

    General ICU the First Affiliated Hospital of Zhengzhou University Henan Key Laboratory of Critical Care Medicine Zhengzhou Key Laboratory of Sepsis Henan Engineering Research Center for Critical Care Medicine Zhengzhou 450052 China;

    General ICU the First Affiliated Hospital of Zhengzhou University Henan Key Laboratory of Critical Care Medicine Zhengzhou Key Laboratory of Sepsis Henan Engineering Research Center for Critical Care Medicine Zhengzhou 450052 China;

    General ICU the First Affiliated Hospital of Zhengzhou University Henan Key Laboratory of Critical Care Medicine Zhengzhou Key Laboratory of Sepsis Henan Engineering Research Center for Critical Care Medicine Zhengzhou 450052 China;

    General ICU the First Affiliated Hospital of Zhengzhou University Henan Key Laboratory of Critical Care Medicine Zhengzhou Key Laboratory of Sepsis Henan Engineering Research Center for Critical Care Medicine Zhengzhou 450052 China;

    Biotherapy Center the First Affiliated Hospital of Zhengzhou University Zhengzhou 450052 China;

    Department of Pharmacy the First Affiliated Hospital of Zhengzhou University Zhengzhou 450052 China;

    School of Biomedical Sciences Charles Sturt University Wagga Wagga 2650 Australia;

    General ICU the First Affiliated Hospital of Zhengzhou University Henan Key Laboratory of Critical Care Medicine Zhengzhou Key Laboratory of Sepsis Henan Engineering Research Center for Critical Care Medicine Zhengzhou 450052 China;

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