A Review of Current Evidence for the Use of Steroids in the Medical Intensive Care Unit

Abstract

Systemic steroids are frequently used in critically ill patients for their anti-inflammatory properties. Potential benefits of these agents should be balanced against their known side effects. In this paper, we review trials assessing the use of systemic steroids in common conditions requiring admission to the intensive care unit. These include septic shock, the acute respiratory distress syndrome, severe pneumonia, COVID-19, and hypercapnic respiratory failure due to chronic obstructive pulmonary disease. We will mainly focus on well-conducted randomized controlled trials to determine whether steroids should be administered to critically ill patients presenting with these conditions.

Keywords

• acute respiratory distress syndrome
• COVID-19
• septic shock
• severe pneumonia
• hypercapnic respiratory failure
• chronic obstructive pulmonary disease