Early Low Dose Steroid Therapy of Acute Respiratory Distress Syndrome

Exclusion Criteria

• •1. Clinical evidence of active and untreated infection.
• •Clarifications:
• •* A known, undrained abscess (e.g. Staphylococcal lung abscess or loculated empyema or intra-abdominal abscess) or a known intravascular nidus of infection (e.g., bacterial or fungal endocarditis) will be a basis for exclusion, even if it is being treated with antibiotics.
• •* A bacterial infection being treated with a standard antibiotic regimen would not be a basis for exclusion.
• •* Disseminated fungal infection, even if being treated, is an exclusion.
• •* Ongoing septic shock, even if on antibiotics is a basis for exclusion.
• •2. Age \<18 years.
• •3. Pregnancy.
• •4. Burns requiring skin grafting.
• •5. Patients with AIDS by CDC criteria, diagnosed by either a documented AIDS defining illness or CD4\<200(see Appendix F); prednisolone therapy \>=300mg(or its equivalent) cumulative dose within 21 days prior to enrollment, or \>15mg/day(or its equivalent) within 7 days prior to enrollment; cytotoxic therapy within 3 weeks.
• •6. Other irreversible chronic disease or condition for which 6 month mortality is estimated ≥ 50%.
• •7. Not committed to full support.
• •8. Severe chronic liver disease (Child-Pugh Class C score\>10 points).
• •9. Transplant patients with the exception of autologous bone marrow transplants.
• •10. Extracorporeal support of gas exchange at the time of study entry (e.g., ECMO).
• •11. Known or suspected adrenal insufficiency.
• •12. Vasculitis with diffuse alveolar hemorrhage.