Critical Care Medicine

Adult Critical Care

A randomized trial of recombinant human granulocyte-macrophage colony stimulating factor for patients with acute lung injury

Paine R III, Standiford TJ, Dechert RE, et al (Univ of Michigan Med School, Ann Arbor; et al) Crit Care Med 40:90-97, 2012^§

Abstract

Rationale

Despite recent advances in critical care and ventilator management, acute lung injury and acute respiratory distress syndrome continue to cause significant morbidity and mortality. Granulocyte-macrophage colony stimulating factor may be beneficial for patients with acute respiratory distress syndrome.

Objectives

To determine whether intravenous infusion of granulocyte-macrophage colony stimulating factor would improve clinical outcomes for patients with acute lung injury/acute respiratory distress syndrome.

Design

A randomized, double-blind, placebo-controlled clinical trial of human recombinant granulocyte-macrophage colony stimulating factor vs. placebo. The primary outcome was days alive and breathing without mechanical ventilatory support within the first 28 days after randomization. Secondary outcomes included mortality and organ failure-free days.

Setting

Medical and surgical intensive care units at three academic medical centers.

Patients

One hundred thirty individuals with acute lung injury of at least 3 days duration were enrolled, out of a planned cohort of 200 subjects.

Interventions

Patients were randomized to receive human recombinant granulocyte-macrophage colony stimulating factor (64 subjects, 250 μg/M²) or placebo (66 subjects) by intravenous infusion daily for 14 days. Patients received mechanical ventilation using a lung-protective protocol.

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