Corticosteroids for H1N1 associated acute lung injury: is it just wishful thinking?

Excerpt

Dear editor: When challenged by a potentially life-threatening infection, intensivists are frequently inclined to prescribe adjunctive therapies with so called immunomodulating effects. However, the story of anti-inflammatory therapies in severe infections has been so far a story of disenchantment. Most of it may be ascribed to an incomplete knowledge of immune and acute phase responses. Corticosteroids have recently been caught in the midst of a huge controversy regarding their indication for severe sepsis. Despite clear evidence of anti-inflammatory effects and of clinical benefit in small single center trials, the alleged survival benefits were not subsequently confirmed by the CORTICUS study. …