Category 14, Item 26
Question
Which adjunctive therapy has a beneficial effect on survival from acute lung injury and the acute respiratory distress syndrome (ARDS) in adults?
Inhaled nitric oxide
Corticosteroids
N-acetyl cysteine
Surfactant
None of the above
Critique
Several adjunctive therapies have been proposed to treat patients with ARDS. Inhaled nitric oxide can reduce airway pressures and pulmonary arterial hypertension. Corticosteroids can reduce bronchospasm and the intensity of lung inflammation. N-acetyl cysteine and surfactant may be useful in preventing alveolar collapse. Unfortunately, none of these or any other adjunctive therapy has proved to affect survival. Length of hospital stay, incidence of pneumonia, and duration of ventilatory support are also not affected.1