Three cases of low dose hydrocortisone infusion for acute respiratory distress syndrome (ARDS) caused by community-acquired pneumonia

Abstract

We have experienced 3 cases of low dose hydrocortisone infusion for acute respiratory distress syndrome (ARDS) caused by community-acquired pneumonia. The patients were 68∼83 years old. Two of them were male and one was female. P/F ratio were 60∼107 mmHg after tracheal intubation. After intravenous bolus of glucocorticoid (prednisolone 50 mg to one patient, hydrocortisone 200 mg to two patients), continuous infusion of hydrocortisone was performed at a rate of 10 mg · hr^-1. In 2 cases, blood gases were improved and the patients were successfully weaned from ventilator on 8th and 9th day. In one case, the patient died on 11th day, caused by toxic shock syndrome. But blood gas was improved until 10th day when her P/F ratio was 236 mmHg. Low dose hydrocortisone infusion for ARDS may have clinical efficacy to improve oxygen exchange.