ArticleJournal of intensive care2020
Use of glucocorticoids in patients with acute respiratory distress syndrome: a meta-analysis and trial sequential analysis.
Article in Journal of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
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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
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Steroid treatment in patients with acute respiratory distress syndrome: a systematic review and network meta-analysis.Journal of anesthesia · 2022Pooled it
- Immunomodulation as Treatment for Severe Coronavirus Disease 2019: A Systematic Review of Current Modalities and Future Directions.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Pooled it
- Decreased mortality in acute respiratory distress syndrome patients treated with corticosteroids: an updated meta-analysis of randomized clinical trials with trial sequential analysis.Critical care (London, England) · 2021Pooled it
- Stress hyperglycemia ratio in risk stratification and treatment optimization for patients on invasive mechanical ventilation: a secondary analysis of the MIMIC-IV database.BMC infectious diseases · 2026Article
- A Comparative Study of Glucocorticoids Efficacy in Acute Respiratory Distress Syndrome.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Low-Dose Corticosteroids for Critically Ill Adults With Severe Pulmonary Infections: A Review.JAMA · 2024Review
- Insights into COVID-19-associated critical illness: a narrative review.Annals of translational medicine · 2023Review
- Glucocorticoid therapy in respiratory illness: bench to bedside.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2022Review
- New Insights on Effects of Glucocorticoids in Patients With SARS-CoV-2 Infection.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022Review
- Article
- Acute Respiratory Distress Syndrome.Emergency medicine clinics of North America · 2022Review
- Impact of Inflammatory Response Modifiers on the Incidence of Hospital-Acquired Infections in Patients with COVID-19.Infectious diseases and therapy · 2021Article
- Revisiting Old Friends: Adjunctive Therapies in Acute Respiratory Distress Syndrome.American journal of respiratory and critical care medicine · 2021Article
- Tailored modulation of the inflammatory balance in COVID-19 patients admitted to the ICU?-a viewpoint.Critical care (London, England) · 2021Article
- The Role of Glucocorticoids in the Management of COVID-19.Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme · 2021Review
- The PDE4 Inhibitor Tanimilast Blunts Proinflammatory Dendritic Cell Activation by SARS-CoV-2 ssRNAs.Frontiers in immunology · 2021Article
- Pragmatic Recommendations for Therapeutics of Hospitalized COVID-19 Patients in Low- and Middle-Income Countries.The American journal of tropical medicine and hygiene · 2020Review
- Current and evolving standards of care for patients with ARDS.Intensive care medicine · 2020Review
- Systemic corticosteroids for management of COVID-19: Saving lives or causing harm?International journal of immunopathology and pharmacologyReview
- Could Exogenous Insulin Ameliorate the Metabolic Dysfunction Induced by Glucocorticoids and COVID-19?Frontiers in endocrinologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute respiratory distress syndrome (ARDS) is a common and disabling disease with high rates of mortality and morbidity. The role of steroids in treating ARDS remains controversial. We aim to examine the evidence behind using glucocorticoids in the management of ARDS from the available studies.
methodsWe performed a literature review of major electronic databases for randomized controlled trials (RCTs) comparing glucocorticoids versus placebo in treating patients with ARDS. Our primary outcome was hospital mortality. Other outcomes included ICU mortality, number of ventilator-free days at day 28, incidence of nosocomial infections, and hyperglycemia. We performed a meta-analysis using a random effects model to calculate risk ratios (RR) and mean difference (MD) with their corresponding 95% confidence intervals (CI). A subsequent trial sequential analysis was performed to examine the strength of evidence and to guard against statistical type I and type II errors for our results.
resultsEight RCTs were included in the final analysis totaling of 1091 patients, with a mean age of 57 ± 16, and 56.2% were male. In our pooled analysis, use of glucocorticoids was associated with a significant reduction in hospital mortality (RR 0.79; 95% CI 0.64-0.98;
conclusionAmong patients with ARDS, use of glucocorticoids is associated with a significant reduction in mortality and duration of mechanical ventilation, without increased risk of hospital-acquired infections. However, based on a trial sequential analysis, these findings may be secondary to a false-positive (type I) error. Further studies are needed for a firm conclusion with guarding against possible statistical errors.
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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.