Use of corticosteroids in acute respiratory distress syndrome: Perspective from an Indian intensive care unit

Abstract

m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 3 ( 2 0 1 7 ) 1 1 8 -1 2Methods: This was a retrospective study at an Indian intensive care unit (ICU) on ARDS patients. Demographic, clinical, laboratory, and imaging parameters were collected. Patients were divided into cohorts based on steroid use, and some received high-dose (2 mg/kg/day), whereas others received low-dose (1 mg/kg/day) steroids. Primary outcomes were in-hospital mortality and secondary outcomes included need for and duration of invasive mechanical ventilation (IMV), IMV-free days, ICU length of stay (LOS), and total LOS. Two-tailed p < 0.05 was considered statistically significant. . There were no differences in outcomes of IMV-free days, ICU LOS, or total LOS. These outcomes were comparable between the high-dose and low-dose steroid users.

Glucocorticoids for acute respiratory distress syndrome: A systematic review with meta‐analysis and trial sequential analysis

“…[5][6][7] Findings in animal studies have aroused great interest in assessing the efficacy of glucocorticoids in ARDS patients. However, different studies have drawn different conclusions; some researchers found that administration of glucocorticoids was associated with better prognosis in ARDS patients, [8][9][10][11][12][13][14] while other studies did not support the routine use of glucocorticoids for ARDS [15][16][17][18][19][20] ; thus, the effect of glucocorticoids in treating ARDS patients remains unclear, and there are contradictions between different guidelines on the use of corticosteroids for ARDS patients. 21,22 Recently, the largest randomized controlled trials (RCTs) published to date found that the administration of glucocorticoids could significantly improve the prognosis of moderate-to-severe ARDS patients (reducing the duration of mechanical ventilation and mortality) without increasing the incidence of adverse events (including hyperglycaemia and infectious complication events).…”

Association between glucocorticoid administration and outcomes in patients with ARDS based on the MIMIC-III database

“…[5,6] However, previous randomized trials failed to provide convincing evidence of consistent results in favor of corticosteroid therapy . [7][8][9] They demonstrated that corticosteroids have advantages over controls in reducing ARDS mortality, the duration of mechanical ventilation, and the length of hospital stay. The MIMIC-III database includes real-world clinical data, reflecting the diversity of actual clinical practice, and offers broad sample coverage with extensive patient data, making it advantageous for rare disease and subgroup analyses.…”