Abstract
The use of corticosteroids as immunosuppressants in critically ill patients is a very complex issue. These potent immunomodulators can be used in the treatment of critically ill patients with severe community-acquired pneumonia (SCAP) and/or septic shock. Local and systemic inflammatory responses are increased in SCAP, thus impairing gas exchange. Also, persistent inflammatory response is associated with higher mortality in patients with COVID-19 and non-COVID-19-related ARDS. However, the risk of administering systemic steroids (methylprednisolone, Dexamethasone, hydrocortisone, etc.) to non-responders is evident. In general, the use of corticosteroids in critically ill patients should not be routine (one size fits all approach) but as personalized and individualized as clinically possible (from one size does not fit all to one size fits one).
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