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Case Reports in Critical Care
Volume 2017 (2017), Article ID 6740532, 3 pages
https://doi.org/10.1155/2017/6740532
Case Report

Effective and Safe Use of Glucocorticosteroids for Rescue of Late ARDS

1Anesthesiology, Università degli Studi di Padova, Padua, Italy
2Cardiovascular Perfusion, University of Virginia Health System, Charlottesville, VA, USA
3Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA

Correspondence should be addressed to Nadia Lunardi; ude.ainigriv@f3ln

Received 19 December 2016; Accepted 6 February 2017; Published 26 February 2017

Academic Editor: Kurt Lenz

Copyright © 2017 Paolo Diana et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe a case of severe refractory hypoxemia requiring prolonged extra corporeal membrane oxygenation (ECMO) support in a case of postpartum acute respiratory distress syndrome (ARDS). The clinical course was marked by persistently poor lung compliance and several complications of ECMO, that is, significant hemolysis, hemothorax, and intracranial bleeding. We report marked improvement of lung mechanics and respiratory function, leading to accelerated separation from ECMO, following rescue administration of low dose methylprednisolone 24 days after the onset of ARDS. Corticosteroid treatment was safe and well tolerated. In contrast with the conclusions of the 2006 ARDS Network trial, our report establishes a case in support of the use of low dose methylprednisolone as a safe and effective rescue treatment option in selected subsets of patients with nonresolving ARDS.