Evaluation of Preventive Pentoxifylline Effect on Acute Respiratory Distress Syndrome (ARDS) Incidence in Traumatic Patients: A Randomized Triple-Blind Placebo-Controlled Trial.

Background: Inflammation is important in the pathophysiology of acute respiratory distress syndrome (ARDS). Traumatic injuries have been assumed to be primary ARDS causes. Recently, pentoxifylline, a phosphodiesterase inhibitor (PEI), was shown to have anti-inflammatory effects and reduce the incidence of ARDS. The present study investigated the impact of preventive pentoxifylline administration in trauma patients prone to ARDS development.

Methods: A total of 62 trauma patients admitted to the Kamyab Hospital in Mashhad,Iran, with ARDS risk who fulfilled the inclusion and exclusion criteria were included in this study. The patients were randomly divided into treatment and placebo groups. The treatment group received 400 mg pentoxifylline 3 times a day, while the control group received placebo tablets thrice for 1 week. Before the intervention and during the study, factors such as heart rate, blood pressure, respiration rate, continuous pulse oximetry, CRP, PO₂, PCO₂, and PH were assessed. Finally, the obtained data were analyzed using SPSS Version 26 via a generalized estimating equations model and an independent t test.

Results: The heart rate was significantly lower in the treatment group than in the placebo group (P = 0.036). In addition, PO₂ levels were remarkably higher in the treatment group (P = 0.040). Changes in respiratory rate (P = 0.064), CRP (P = 0.341), PH (P = 0.910), PCO₂ (P = 0.892), HCO₃ (P = 0.172), systolic blood pressure (P = 0.302), and SPO₂ (P = 0.350) were not significantly different between the 2 groups. In addition, no significant difference was observed in the incidence and severity of ARDS between the 2 groups.

Conclusion: The findings of this study revealed that pentoxifylline administration to trauma patients had no beneficial effects on ARDS but improved some vital signs and laboratory variations.