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Thus, contrary to Annane's recommendation (in the editorial accompanying this paper) 6 that all patients with ARDS (except those at > 2 weeks) be treated with prolonged glucocorticosteroids as Meduri et al have proposed, I suggest caution until other larger studies examine this protocol. The findings are promising, but I believe additional evidence is needed to more clearly guide our usage of glucocorticosteroids in patients with ARDS. Those physicians who decide to use the therapy recommended by Meduri et al now must at least carefully monitor their patients for infection and neuromuscular weakness, aggressively manage blood glucose, and use low-tidal-volume ventilation.

Ardsnet steroids

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