Table 2

Comparison of old and new trials investigating methylprednisolone use in acute respiratory distress syndrome (ARDS)

1980s trials1990s trials
Timing of ARDS<2 days7–14 days (unresolved)
Dosage120 mg·kg−1·day−12 mg·kg−1·day−1
Duration1 dayAverage 30 days
Understanding of the HIR in ARDSMassive, short-livedProlonged, initial intensity affects duration
Understanding of GCT in ARDSReversibility lost earlyReversibility lost with end-stage fibrosis
GCTMassive, short-courseLower dose, prolonged until resolution

  • HIR: host inflammatory response

  • GCT: glucocorticoid treatment