Table 1.
Selected pharmacotherapies found to be ineffective for ARDS in human clinical trials
| Potential mechanisms | Key studies | Comments | |
|---|---|---|---|
| Activated protein C | Anticoagulant, anti-inflammatory | Liu et al138 | .. |
| Anti-endotoxin antibodies | Bind endotoxin and thereby reduce inflammatory response | Bigatello et al139 | .. |
| Aspirin | Anti-inflammatory via antiplatelet effects | Kor et al140 | Did not reduce ARDS development in patients at high risk |
| β-agonists | Improved alveolar fluid clearance | Matthay et al,141 Gao Smith et al142 | .. |
| Ibuprofen | Anti-inflammatory, via inhibition of cyclooxygenase | Bernard et al143 | Did not reduce ARDS development in sepsis |
| Interferon β-1a | Improve pulmonary endothelial barrier function | Ranieri et al144 | .. |
| Keratinocyte growth factor | Promote epithelial repair | McAuley et al145 | .. |
| Ketoconazole | Anti-inflammatory | The ARDS Network146 | .. |
| Lisofylline | Anti-inflammatory | The ARDS Network147 | .. |
| Neutrophil elastase inhibitor (eg, sivelestat) | Anti-inflammatory | Zeiher et al,148 Iwata et al149 | .. |
| Nitric oxide (inhaled) | Pulmonary vasodilatation, improve V/Q mismatch | Gebistorf et al150 | Improved oxygenation; increased acute kidney injury |
| Omega-3 fatty acids | Anti-inflammatory | Rice et al134 | .. |
| Procysteine and N-acetylcysteine | Reduction in oxidant injury via restoring glutathione | Bernard et al151 | .. |
| Prostaglandin E1 | Pulmonary vasodilatation, improve V/Q mismatch | Fuller et al,152 Vincent et al153 | .. |
| Statins (eg, simvastatin, rosuvastatin) | Anti-inflammatory; endothelial stabilisation | McAuley et al,154 Truwit et al155 | .. |
| Surfactant | Promote epithelial repair, reduce atelectrauma | Spragg et al156 | Effective in neonatal respiratory distress syndrome |
ARDS=acute respiratory distress syndrome. V/Q=ventilation–perfusion.