DEXA-ARDS study – Villar et al. in Lancet Resp –
https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(19)30417-5.pdf
https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(19)30417-5.pdf
RCT of 277 patients with ARDS P/F<200 todexa 20 daily x 5d then down to 10mg x5d or extubation; improved outcomes vent-free days, mortality (21% vs 36% at 60 days)! Rich says every few years steroids for ARDS come back into vogue but then another study shows no benefit or harm and the cyclerepeats though.
Pulmcrit has a nice summary of the previous studies too of steroids in ARDS – https://emcrit.org/pulmcrit/dexa-ards/