Pro/con clinical debate: steroids are a key component in the treatment of SARS. Pro: Yes, steroids are a key component of the treatment regimen for SARS.
SARS (severe acute respiratory syndrome) proved an enormous physical and emotional challenge to frontline health care workers throughout the world in late 2002 through to mid 2003. A large percentage of patients (many being health care workers themselves) became critically ill. Unfortunately, clinicians caring for these individuals did not have the advantage of previous experience or research data on which to base treatment decisions. As a result, at least early in the outbreak, a 'best guess approach' and/or anecdotes drove therapy. In many centres systemic steroids, which carry many potential downsides, became a mainstay of therapy. In this issue of Critical Care, two groups that have frontline experience of SARS debate the role of steroids. Let us hope and pray together that we never have the patient population needed to resolve the questions the two sides raise.
Gomersall
Charles D
CD
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D004196:Disease Outbreaks; D006801:Humans; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000209:etiology; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000209:etiology; D045169:Severe Acute Respiratory Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D013256:Steroids