Anti-inflammatory therapy for acute lung injury. A review of animal and clinical studies.

The adult respiratory distress syndrome (ARDS) continues to demonstrate high mortality. This syndrome is frequently observed as a remote complication of another disease process and is characterized by a significant inflammatory component. The purpose of this review is to compare and contrast published research on the use of anti-inflammatory agents, steroidal and nonsteroidal, in animal models of acute lung injury. Emphasis is given to the nature of the experimental pulmonary injury, infusion (ie, oleic acid and zymosan-activated plasma) or bacteriologically (ie, endotoxin and live bacteria) induced and the timing of drug administration relative to induction of the insult. The clinical data available on the use of these drugs in ARDS are discussed, and a rationale is presented for future clinical trials in these patients.