Observational studyIntensive care medicine2015
Corticosteroid exposure in pediatric acute respiratory distress syndrome.
Observational study in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 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
38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 2.Arthritis & rheumatology (Hoboken, N.J.) · 2021Guideline
- American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 1.Arthritis & rheumatology (Hoboken, N.J.) · 2020Guideline
- An Unsettled Promise: The Newborn Piglet Model of Neonatal Acute Respiratory Distress Syndrome (NARDS). Physiologic Data and Systematic Review.Frontiers in physiology · 2019Pooled it
- Inflammatory and tissue injury marker dynamics in pediatric acute respiratory distress syndrome.The Journal of clinical investigation · 2024Trial
- Unraveling mortality risk in pediatric acute respiratory distress syndrome: key biomarkers and pathophysiological insights.Pediatric research · 2026Review
- Evaluating treatment and care outcomes for neuromuscular diseases in a pediatric intermediate care setting.Frontiers in pediatrics · 2025Article
- New perspectives on extracorporeal life support: expert teams and precise selection of candidates are transforming pediatric cancer and hematopoietic cell transplantation care.Frontiers in oncology · 2025Article
- Evaluation of interleukin-1 and interleukin-6 receptor antagonists in a murine model of acute lung injury.Experimental physiology · 2024Article
- Time to split: biomarker trajectories in pediatric acute respiratory distress syndrome hint at underlying disease.The Journal of clinical investigation · 2024Article
- Association between Age and Mortality in Pediatric and Adult Acute Respiratory Distress Syndrome.American journal of respiratory and critical care medicine · 2024Article
- Observational
- Corticosteroids treatment for pediatric acute respiratory syndrome: A critical review.Saudi medical journal · 2023Review
- Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2023Review
- Understanding clinical and biological heterogeneity to advance precision medicine in paediatric acute respiratory distress syndrome.The Lancet. Respiratory medicine · 2023Review
- Management of paediatric acute respiratory distress syndrome.BJA education · 2022Review
- Potential therapeutics in pediatric acute respiratory distress syndrome: what does the immune system have to offer? A narrative review.Translational pediatrics · 2021Review
- Efficacy of intratracheal budesonide-surfactant combined therapy in surfactant-insufficient rat lungs with lipopolysaccharide insult.Journal of the Chinese Medical Association : JCMA · 2021Article
- Paediatrics: how to manage acute respiratory distress syndrome.Drugs in context · 2021Review
- Dexamethasone fails to improve bleomycin-induced acute lung injury in mice.Physiological reports · 2019Article
- Steroids in pediatric acute respiratory distress syndrome.Annals of translational medicine · 2019Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeUse of systemic corticosteroids in acute respiratory distress syndrome (ARDS) remains controversial, and studies in children are lacking.
methodsWe performed an observational, single-center study in a prospectively enrolled cohort of children meeting criteria for ARDS (both Berlin 2012 and AECC 1994 acute lung injury) and pediatric ARDS (PARDS, as defined by PALICC 2015). Comprehensive analysis of corticosteroid utilization was planned, and detailed information collected on corticosteroid use, timing, treatment duration, and cumulative dose while mechanically ventilated. We assessed the association between corticosteroid exposure >24 h and outcomes.
resultsOf the 283 children with PARDS (37 deaths, 13%), 169 (60%) received corticosteroids for >24 h while ventilated: 51% hydrocortisone, 41% methylprednisolone, 5% dexamethasone, 3% combination of corticosteroids. Corticosteroid exposure >24 h was associated with increased mortality, fewer ventilator-free days at 28 days (VFD), and longer duration of ventilation in survivors in unadjusted analyses (all p < 0.05). Multivariate and propensity score adjusted analyses confirmed independent association of corticosteroid exposure with fewer VFD and longer duration of ventilation in survivors, but not with mortality. In planned analyses of high-risk subgroups, no benefit was seen with corticosteroids exposure, with fewer VFD associated with corticosteroid exposure >24 h in patients with ≥3 organ failures and immunocompromised patients.
conclusionsCorticosteroid exposure >24 h was independently associated with fewer VFD and longer duration of ventilation in survivors, even after adjustment for key potential confounders, including severity of illness, oxygenation index, immunocompromised status, and number of organ failures.
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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.