Intrapleural Methylprednisolone Injection for Multiple Organ Failure With Acute Respiratory Distress Syndrome (IP steroid)
Acute Respiratory Distress Syndrome (ARDS), Multiple Organ Failure
About this trial
This is an interventional treatment trial for Acute Respiratory Distress Syndrome (ARDS) focused on measuring Acute Respiratory Distress Syndrome, Multi-organ Dysfunction Syndrome, Extracorporeal Membrane Oxygenation
Eligibility Criteria
Inclusion Criteria:
- All of the patients had failure of at least 2 organs acquiring arteriovenous or venovenous ECMO support
All of the patients met the criteria as below:
- blood gas parameters of PaO2/FiO2 < 100
- bilateral pulmonary infiltration on chest radiographic images
- 100% oxygen demand in case of ventilation and ECMO flow
- hemodynamic instability requiring high catecholamine infusion
All the patients had scoring system, which were calculated by the physician within 24 h of admission of the patients into the hospital.
- sequential organ failure assessment score (SOFA) ≥ 10
- Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 20
- inotropic score ≥ 10
- multiple organ dysfunction (MOD) score ≥ 10
Exclusion Criteria:
- uncontrollable underlying disease
- life expectancy of less than 24 h
- immunosuppression
- neutrophil count of less than 0.3 × 109/L
- brainstem death
- history of long-term corticosteroid use during the past 6 months.
Sites / Locations
- Department of Surgery, National Taiwan University Hospital
Arms of the Study
Arm 1
Arm 2
Sham Comparator
Experimental
conventional ECMO with intravenous steroid
Drug: intrapleural steroid instillation
refractory acute respiratory distress syndrome and multi-organ dysfunction syndrome unresponsive to conventional extracorporeal membrane oxygenation
refractory acute respiratory distress syndrome and multi-organ dysfunction syndrome unresponsive to conventional extracorporeal membrane oxygenation