Respiratory failure & ventilation
Corticosteroids in ARDS: old controversies, new insights, and future directions
Authors' conclusion
Corticosteroids should therefore be considered a context-dependent therapy whose benefit is influenced by etiology, disease stage, inflammatory phenotype, and timing of administration.
Study context
- Population
- Patients with ARDS, including COVID-19 ARDS and severe community-acquired pneumonia
- Comparison
- Corticosteroids in ARDS
Main finding
As reported in the abstract
- Clinical evidence supports corticosteroids in moderate-to-severe ARDS, particularly COVID-19 ARDS and severe community-acquired pneumonia, with reductions in mortality and duration of mechanical ventilation
- Treatment effects heterogeneous across etiologies and biological subphenotypes
- Hyperinflammatory phenotypes and septic ARDS appear more likely to benefit; evidence limited or conflicting in influenza-associated and non-septic ARDS
Safety
Long-term effects and adverse outcomes (metabolic complications, ICU-acquired weakness)
- Remain insufficiently characterized
Original publication
Corticosteroids in ARDS: old controversies, new insights, and future directions. Intensive Care Med. Published 13 August 2026. doi:10.
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