Decreased mortality in acute respiratory distress syndrome patients treated with corticosteroids: an updated meta-analysis of randomized clinical trials with trial sequential analysis

• Published in: Critical care (London, England) England), 2021-03, Vol.25 (1), p.122-10, Article 122
• Main Authors: Lin, Ping, Zhao, Yuean, Li, Xiaoqian, Jiang, Faming, Liang, Zongan
• Format: Article
• Language: English
• Subjects: Acute respiratory distress syndrome; Adrenal Cortex Hormones - therapeutic use; Bias; Clinical trials; Corticosteroids; Critical care; Dosage and administration; Drug therapy; Glucocorticoids; Humans; Hyperglycemia; Infections; Meta-analysis; Mortality; Mortality - trends; Patient outcomes; Randomized clinical trial; Randomized Controlled Trials as Topic - statistics & numerical data; Respiratory distress syndrome; Respiratory Distress Syndrome - drug therapy; Respiratory Distress Syndrome - mortality; Ventilators
• ISSN: 1364-8535; 1466-609X; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-021-03546-0

The possible benefits associated with corticosteroid treatment in acute respiratory distress syndrome (ARDS) patients are not fully known. We conducted an updated meta-analysis to assess the effect of corticosteroids in the treatment of patients with ARDS. We systematically searched MEDLINE, Embase, and the Cochrane Library from inception to January 2021 via Ovid to identify randomized controlled trials evaluating the efficacy of glucocorticoids in the treatment of patients with ARDS. The primary outcome was hospital mortality. Secondary outcomes included the number of ventilator-free days at day 28, oxygenation improvement (PaO /FIO  ratios), and adverse events. Nine studies with 1371 participants were analyzed. The pooled analysis revealed that glucocorticoid use was associated with reduced mortality [relative risk (RR), 0.83; 95% confidence interval (CI) 0.74-0.93; P