We read with interest the evidence-based recommendations for the use of prolonged corticosteroids in early moderate to severe acute respiratory distress syndrome (ARDS) published in Critical Care Medicine by the Corticosteroid Guideline Task Force of SCCM and ESICM. Whether corticosteroids have to be administered in adult patients with ARDS remains a matter of debate. Based on nine randomized controlled trials (RCTs), including eight RCTs selected in the meta-analysis of Meduri et al. and one additional recent RCT, the task force found that the use of prolonged corticosteroids in early ARDS has a beneficial effect on in-hospital mortality.

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