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Related Experiment Videos

Corticosteroids in ARDS. An evidence-based review.

John M Luce1

  • 1Department of Medicine and Anesthesia, University of California, Medical-Surgical Intensive Care Unit, San Francisco General Hospital, San Francisco, California, USA. john_luce@sfgh.org

Critical Care Clinics
|March 26, 2002
PubMed
Summary

Corticosteroids are not established treatments for preventing or relieving acute respiratory distress syndrome (ARDS). Current evidence does not support their use for reducing mortality in early sepsis or ARDS, with inconclusive findings for late ARDS and low-dose treatments.

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Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Pharmacology

Background:

  • Corticosteroids are used for Pneumocystis carinii pneumonia but their role in ARDS is unclear.
  • High-dose corticosteroids have not demonstrated reduced mortality in early sepsis, septic shock, or ARDS.
  • Existing research on corticosteroids for ARDS lacks definitive conclusions.

Purpose of the Study:

  • To evaluate the efficacy of corticosteroids in preventing or treating acute respiratory distress syndrome (ARDS).
  • To assess the impact of high-dose and low-dose corticosteroids on mortality in patients with sepsis, septic shock, and ARDS.

Main Methods:

  • Review of existing studies on corticosteroid use in ARDS, sepsis, and septic shock.
  • Analysis of data regarding high-dose corticosteroid administration in early stages of critical illness.

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  • Examination of studies investigating low-dose corticosteroids in patients with potential relative adrenal insufficiency.

    • Main Results:

    • High-dose corticosteroids did not reduce mortality in early sepsis, septic shock, or ARDS through anti-inflammatory effects.
    • One small, inconclusive study suggested a potential mortality benefit of corticosteroids in late ARDS.
    • Studies on low-dose corticosteroids for sepsis/septic shock with potential adrenal insufficiency yielded inconclusive results regarding mortality and ARDS development.

    Conclusions:

    • A definitive role for corticosteroids in preventing or treating ARDS remains unestablished.
    • Current evidence does not support the routine use of high-dose corticosteroids for early ARDS or sepsis-related mortality.
    • Further research is needed to clarify the potential benefits and risks of low-dose corticosteroids in specific patient populations with critical illness.