ArticleIntensive care medicine2008
Steroid treatment in ARDS: a critical appraisal of the ARDS network trial and the recent literature.
Article in Intensive care medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
66 citing papers in PubMed, 5 syntheses or guidelines pooled it, 169 citations in OpenAlex.
- Prolonged glucocorticoid treatment is associated with improved ARDS outcomes: analysis of individual patients' data from four randomized trials and trial-level meta-analysis of the updated literature.Intensive care medicine · 2016Pooled it
- [Corticosteroid administration for acute respiratory distress syndrome : therapeutic option?].Der Anaesthesist · 2012Pooled it
- Corticosteroids in the treatment of community-acquired pneumonia in adults: a meta-analysis.PloS one · 2012Pooled it
- Guidelines on management of human infection with the novel virus influenza A (H1N1)--a report from the Hospital das Clínicas of the University of São Paulo.Clinics (Sao Paulo, Brazil) · 2009Guideline
- Corticosteroids in the prevention and treatment of acute respiratory distress syndrome (ARDS) in adults: meta-analysis.BMJ (Clinical research ed.) · 2008Pooled it
- Dexamethasone inhibits endotoxin-induced coagulopathy in human lungs.Journal of thrombosis and haemostasis : JTH · 2016Trial
- Trial
- Effects of methylprednisolone infusion on markers of inflammation, coagulation, and angiogenesis in early acute respiratory distress syndrome.Critical care medicine · 2012Trial
- Designing and conducting a randomized trial for pandemic critical illness: the 2009 H1N1 influenza pandemic.Intensive care medicine · 2012Trial
- Endothelial-Epithelial Crosstalk Drives Alveolar-Capillary Barrier Dysfunction in ARDS.Journal of inflammation research · 2026Review
- Curcumin ameliorates heatstroke-induced lung injury by activating the PI3K/AKT pathway.Naunyn-Schmiedeberg's archives of pharmacology · 2025Article
- High-Dose Corticosteroids in Critically Ill COVID-19 Patients: A Retrospective Cohort Study from Suriname.Journal of inflammation research · 2025Article
- Glucocorticoid use in acute respiratory failure from pulmonary causes and association with early changes in the systemic host immune response.Intensive care medicine experimental · 2024Article
- Involvement of endoplasmic reticulum and histone proteins in immunomodulation by TLR4-interacting SPA4 peptide againstInfection and immunity · 2023Article
- Clinical Characteristics and Predictors of Mortality in Critically Ill Adult Patients with Influenza Infection.International journal of environmental research and public health · 2021Article
- The Role of Glucocorticoids in the Management of COVID-19.Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme · 2021Review
- The Role of Glucocorticoids in the Treatment of ARDS: A Multicenter Retrospective Study Based on the eICU Collaborative Research Database.Frontiers in medicine · 2021Article
- Novel Antiviral Strategies in the Treatment of COVID-19: A Review.Microorganisms · 2020Review
- Current Pharmacological Approach to ARDS: The Place of Bosentan.The Eurasian journal of medicine · 2020Review
- Acquired Immunodeficiency from Maternal Chemotherapy and Severe PrimaryCase reports in pediatrics · 2020Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 9 institutions in 5 countries.
Funding
Abstract
objectivesTo compare the design and results of randomized trials investigating prolonged glucocorticoid treatment (> or =7 days) in patients with acute lung injury-acute respiratory distress syndrome (ALI-ARDS), and review factors affecting response to therapy, including the role of secondary prevention.
designTrials were retrieved from the Cochrane Central Register of Controlled Trials (CENTRAL). Two investigators collected data on study characteristics, treatment intervention, and outcomes. The methodological quality of trials was determined and data were analyzed with Review Manager 4.2.3. MEASUREMENTS AND
resultsFive selected trials (n=518) consistently reported significant improvement in gas exchange, reduction in markers of inflammation, and decreased duration of mechanical ventilation and intensive care unit stay (all p<0.05). Two early small clinical trials showed marked reductions in the relative risk (RR) of death with glucocorticoid therapy (RR=0.14, 95% CI 0.04-0.53; p=0.004, I2=0%). Three subsequent larger trials, when combined, although nominally beneficial, did not reproduce the marked reductions observed in the earlier trials (RR=0.84; 95% CI 0.68-1.03; p=0.09, I2=9.1%), but achieved a distinct reduction in the RR of death in the larger subgroup of patients (n=400) treated before day 14 of ARDS [82/214 (38%) vs. 98/186 (52.5%), RR=0.78; 95% CI 0.64-0.96; p=0.02, I2=0%].
conclusionsProlonged glucocorticoid treatment substantially and significantly improves meaningful patient-centered outcome variables, and has a distinct survival benefit when initiated before day 14 of ARDS.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.