Evidence map›Paper›PMID 26545141›Full record

Trial reportCytokine2016

Regulation of inflammatory biomarkers by intravenous methylprednisolone in pediatric ARDS patients: Results from a double-blind, placebo-controlled randomized pilot trial.

Andreas Schwingshackl, Dai Kimura, Cynthia R Rovnaghi, Jordy S Saravia, Stephania A Cormier, Bin Teng, Alina N West, Umberto G Meduri, Kanwaljeet J S Anand

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Cytokine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 pooled it
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2019
    Pooled it
  3. Pooled it
  4. Trial
  5. Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2023
    Review
  6. Article
  7. Biomarkers in pediatric acute respiratory distress syndrome.Annals of translational medicine · 2019
    Review
  8. Corticosteroids in Acute Lung Injury: The Dilemma Continues.International journal of molecular sciences · 2019
    Review
  9. Article
  10. Review
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Andreas SchwingshacklDepartment of Pediatrics, Mattel Children's Hospital at UCLA, Los Angeles, CA, United States. Electronic address: aschwingshackl@gmail.com.
Dai KimuraDepartment of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.
Cynthia R RovnaghiPain Neurobiology Laboratory, University of Tennessee Health Science Center, Memphis, TN, United States.
Jordy S SaraviaDepartment of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.
Stephania A CormierDepartment of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.
Bin TengDepartment of Physiology, University of Tennessee Health Science Center, Memphis, TN, United States.
Alina N WestDepartment of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.
Umberto G MeduriDepartment of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, United States.
Kanwaljeet J S AnandDepartment of Pediatrics, Stanford University, Stanford, CA, United States.
University of Tennessee Health Science Center · USMattel Children's Hospital · USStanford University · US

Funding

Role of microbiota in increased influenza severity due to particulate matter exposureP42ES013648 · NIEHS · LOUISIANA STATE UNIV A&M COL BATON ROUGE · PI LOMNICKI, SLAWO M · 2009 to 2024
$27.6M
The Role of IL4R Alpha in Neonatal RSV ImmunopathologyR01AI090059 · NIAID · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI CORMIER, STEPHANIA A · 2011 to 2025
$6.7M
Combustion Generated PM0.1 and Predisposition to AsthmaR01ES015050 · NIEHS · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI CORMIER, STEPHANIA A · 2006 to 2022
$4.6M
The Role of 2-Pore Domain Potassium Channels in Acute Lung Injury.K08HL118118 · NHLBI · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI SCHWINGSHACKL, ANDREAS · 2014 to 2018
$792k
NHLBI NIH HHS HL118118-01A1NHLBI NIH HHS K08 HL118118NIAID NIH HHS R01 AI090059NIAID NIH HHS R01AI090059NIEHS NIH HHS P42 ES013648NIEHS NIH HHS P42ES013648NIEHS NIH HHS R01 ES015050NIEHS NIH HHS R01ES015050
6 · The paper itself

Abstract

objectiveA double-blind, randomized controlled trial showed that low-dose glucocorticoid therapy in pediatric ARDS patients is feasible and may improve both ventilation and oxygenation indices in these patients. However, the molecular mechanisms underlying potential changes in outcomes remain unclear. Based on these clinical findings, this study was designed to examine the effects of intravenous methylprednisolone on circulating inflammatory biomarkers in pediatric ARDS patients.

designDouble-blind, placebo-controlled randomized trial with blood collection on study entry and day 7.

settingTertiary care children's hospital. PATIENTS: Children (0-18years) with ARDS undergoing mechanical ventilation.

interventions35 children were randomized within 72h of mechanical ventilation. The glucocorticoid group received methylprednisolone 2mg/kg loading dose followed by 1mg/kg/day continuous infusion from days 1 to 7. Both groups were ventilated following the ARDSnet recommendations. WBC and differential cell counts, plasma cytokines and CRP levels, and coagulation parameters were analyzed on days 0 and 7.

resultsAt study entry, the placebo group had higher IL-15 and basophil levels. On day 7, in comparison to study entry, the placebo group had lower IL-1α, IFN-γ and IL-10 levels. The glucocorticoid group had lower INF-α, IL-6, IL-10, MCP-1, G-CSF and GM-CSF levels, and higher IL-17α levels on day 7 in comparison to study entry. Total and differential cell counts remained unchanged within the placebo group between days 0 and 7, whereas in the glucocorticoid group total WBC and platelets counts were increased on day 7. Pearson's correlation studies within the placebo and glucocorticoid groups revealed positive and negative correlations between cytokine levels, cell counts, coagulation parameters and relevant clinical parameters of disease severity identified in our previous study. Multiple regression models identified several cytokines as predictors for alterations in clinical parameters of disease severity.

conclusionThis pilot study shows the feasibility of simultaneously measuring multiple inflammatory cytokines, cell counts and coagulation parameters in pediatric ARDS patients. We report statistical models that may be useful for future, larger trials to predict ARDS severity and outcomes.

Indexed as

Acute DiseaseAdolescentBiomarkersChildChild, PreschoolC-Reactive ProteinCytokinesDouble-Blind MethodFemaleGlucocorticoidsHumansInfantInfant, NewbornInflammation MediatorsInfusions, IntravenousLung DiseasesBiomarkersC-Reactive ProteinCytokinesGlucocorticoidsInflammation MediatorsMethylprednisoloneARDSChemokinesCytokinesGlucocorticoidsInflammationLung injuryMediatorsPediatricsSteroids

Identifiers

PMID26545141
PMCPMC4666843
OpenAlexW2190934473

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.