Prostaglandin E₁ and survival in patients with the adult respiratory distress syndrome: A prospective trial

A 7-day infusion of PGE₁, an immunomodulator, was evaluated in a prospective, placebo-controlled, double-blinded trial in surgical patients with ARDS. The drug seemed to improve pulmonary function - only two PGE₁ patients died with severe pulmonary failure compared with nine placebo patients (p=0.01). Survival at 30 days after the end of the infusion - the predetermined end point of the study - was significantly better in the pati ents given PGE₁ (p=0.03), with 15 of 21 PGE₁ patients (71%) alive at this time compared with seven of 20 placebo patients (35%). Improvement in overall survival in the PGE₁ patients did not reach statistical significance (p=0.08). Overall survival in patients initially free of severe organ failure, however, was significantly better in the PGE₁ patients (p=0.03). Of the six PGE₁ patients free of severe organ failure at time of entry, all survived to leave the hospital; of the 10 placebo patients initially free of severe organ failure, four survived. The drug had no serious side effects and did not potentiate susceptibility to infection. PGE₁ is a promising agent for the treatment of ARDS.