Are Corticosteroids Beneficial in ARDS?

In a large U.S. trial, steroid therapy was not associated with a lower mortality rate.

In 1998, a very small randomized trial suggested that a prolonged course of moderate-dose corticosteroid therapy, starting after at least 1 week of mechanical ventilation, was beneficial for patients with acute respiratory distress syndrome (ARDS; Journal Watch Jul 21 1998). Finally, a larger randomized multicenter U.S. trial has been completed.

The investigators enrolled 180 mechanically ventilated patients with ARDS of least 7 days’ duration, with persistent infiltrates and PaO₂:FiO₂ ratios less than 200. Patients received either intravenous methylprednisolone (starting with 0.5 mg/kg every 6 hours for 14 days and then tapered during the next several weeks) or placebo.

Mortality rates were identical in the 2 groups — 29% at day 60 and 32% a…

Reviewing Author

Allan S. Brett, MD