PT  - JOURNAL ARTICLE
AU  - T A Leahy
AU  - A Chauhan
AU  - V Nicholas
AU  - P Patel
AU  - J Alcada
AU  - P Bianchi
AU  - F Caetano
AU  - S Desai
AU  - J Doyle
AU  - P Molyneux
AU  - S Ledot
AU  - S Padley
AU  - A Devaraj
AU  - C A Ridge
AU  - B Rawal
AU  - M Passariello
AU  - S Price
AU  - C Morgan
AU  - M Kokosi
AU  - B Patel
AU  - A Wells
AU  - G Ball
AU  - T Xu
AU  - A Bashir
AU  - C Remmington
AU  - S Singh
TI  - Responder status and long term outcomes of critically ill patients with ARDS receiving high dose steroids as rescue therapy in a specialist acute respiratory failure centre
AID  - 10.1183/13993003.congress-2022.2979
DP  - 2022 Sep 04
TA  - European Respiratory Journal
PG  - 2979
VI  - 60
IP  - suppl 66
4099  - http://erj.ersjournals.com/content/60/suppl_66/2979.short
4100  - http://erj.ersjournals.com/content/60/suppl_66/2979.full
SO  - Eur Respir J2022 Sep 04; 60
AB  - Background: High-dose steroids (HDS) are used in specialist settings for the treatment of ARDS with features suggesting steroid responsiveness or as a last resort. Our previous case-matched cohort demonstrated that HDS increase 6mo. mortality (Remmington et. al, 2019).Aims and objectives: Identify if response to HDS predicted favourable outcomes.Methods: A retrospective observational study from a tertiary specialist respiratory ICU identified 79 patients (5 excluded) between 2009-2017 who received HDS for ARDS (AECC/Berlin criteria). Patients were grouped according to the change in lung injury score (LIS) between days 0 and 10 following HDS initiation. A modified LIS (excluding PF ratios for patients on ECMO) was used. Changes in LIS were grouped as follows; full responders (FR) ≥ 2, partial responders (PR) ≥ 1 and < 2, and non-responders (NR) < 1.Results: This study identified 7 (9.5%) FR, 14 (18.9%) PR, and 53 (71.6%) NR. Figure 1 shows the mortality for each group, which was significantly reduced when comparing the combined PR+FR groups to the NR group (p (log rank test) < 0.0001).View this table:Figure 1 – mortality over time in patients with different LIS responsesConclusions: A low proportion (28.4%) of ARDS patients given HDS had a FR or PR by day 10 yet these patients had significantly reduced mortality at 24mo. Further research using modified LIS to predict steroid responsiveness may assist clinicians in selecting ARDS patients for rescue therapy.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 2979.This article was presented at the 2022 ERS International Congress, in session “-”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).