During multidisciplinary rounds, a discussion is held regarding the use of medications in acute respiratory distress syndrome (ARDS). Which statement is most accurate based upon published research findings?
1. Corticosteroids are used for their anti-inflammatory property to manage the cytokine-mediated inflammatory response in ARDS.
2. Exogenous surfactant therapy is more beneficial to adult patients with ARDS than when it is given to neonates.
3. Cytokine inhibitors were shown to decrease mortality rates.
4. Inhaled nitrous oxide promotes blood flow to ventilated areas of the lungs.
4
Rationale 1: The use of corticosteroids is controversial with conflicting studies on its effectiveness in improving outcomes.
Rationale 2: Surfactant therapy has proven very helpful in neonates but not in adults with ARDS.
Rationale 3: Cytokine inhibitor study was stopped after 28 days when designated outcomes were not met and an increased mortality was noted.
Rationale 4: Inhaled nitrous oxide improves oxygenation by promoting blood flow to well ventilated areas of the lung, but has not been proven to improve outcomes at this time. It is proposed as a rescue therapy for refractory cases of ARDS.
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