SynthesisBMC anesthesiology2025
Efficacy and safety of corticosteroids in critically ill patients: a systematic review and meta-analysis.
Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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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.
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Who cites it
6 citing papers in PubMed.
- Hemodynamic trajectory phenotypes may modify associations between corticosteroid timing and outcomes in septic shock.Journal of clinical monitoring and computing · 2026Article
- A clinician's guide to corticosteroid therapy in pneumonia and critical illness: agent selection, dosing, monitoring, and interactions.Pneumonia (Nathan Qld.) · 2026Review
- Corticosteroids with or without antiviral therapy in elderly patients hospitalized with COVID-19 during the Omicron era: A multicenter real-world study.Journal of virus eradication · 2026Article
- Acyl-CoA-binding protein (ACBP): a poor-prognosis biomarker in sepsis and a target for disease mitigation.Signal transduction and targeted therapy · 2026Article
- The Critical Role of Steroid Regimen for Lung Repair in Experimental Diffuse Alveolar Damage.International journal of molecular sciences · 2026Article
- Risk factors for ICU-acquired weakness in patients undergoing mechanical ventilation: a systematic review and meta-analysis.Journal of thoracic disease · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe overall benefits and potential risks of corticosteroids, frequently administered to critically ill patients remain uncertain. This systematic review and meta-analysis evaluated the efficacy and safety of corticosteroid therapy in critically ill patients with severe community-acquired pneumonia, sepsis or septic shock, or acute respiratory distress syndrome. We hypothesized that corticosteroids reduce short-term mortality in critically ill patients.
methodsWe performed a search of Medline, Embase, and the Cochrane Central Register of Controlled Trials from database inception up to November 30, 2024. The search was limited to randomized controlled trials in human populations published in English. Dichotomous outcomes are reported as relative risk (RRs) and continuous outcomes as mean differences (MDs), both with 95% confidence intervals (CIs). The primary outcome was short-term mortality (28-day or nearest reported). Secondary outcomes included ICU/hospital length of stay, mechanical ventilation duration, ventilator-free days at 28 days, oxygenation index, reversed shock in sepsis or septic shock, and adverse events. We evaluated heterogeneity using I
resultsForty-three randomized controlled trials (n = 10853) were included. Corticosteroids reduced short-term mortality in critically ill patients compared to placebo (RR, 0.85; 95% CI, 0.77-0.94). Corticosteroid treatment for critically ill patients reduced intensive care unit (MD, - 2.02 days; 95% CI, - 3.14 - -0.90) and hospital (MD, - 2.66 days; 95% CI, - 4.58 - -0.74) lengths of stay, and duration of mechanical ventilation (MD, - 4.24 days; 95% CI, - 6.38 - -2.10); it increased ventilator-free days at 28 days (MD, 2.83 days; 95% CI, 1.20-4.47), improved oxygenation index (PaO
conclusionsSubgroup analysis indicated that early initiation (≤ 72 h), low-dose (e.g., < 400 mg/day hydrocortisone equivalent), and prolonged (≥ 7 days) corticosteroid therapy was associated with reduced short-term mortality in critically ill patients with severe community-acquired pneumonia or acute respiratory distress syndrome. For septic shock, combination therapy (hydrocortisone plus fludrocortisone) may enhance efficacy. CLINICAL
trial registrationPROSPERO: CRD42024517843.
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