急性呼吸窘迫症候群(Acute respiratory distress syndrome，ARDS) 已經被提出超過50年，雖然有很多治療方法可以減低死亡率，整體的預後仍然不佳。在這些治療方法中，類固醇的地位一直不明確，臨床醫師對於使用適應症多有歧見。本文回顧一些文獻來定位類固醇在ARDS 上的角色。雖然類固醇用在ARDS 的文獻數目及病人數量不多，但實證證據顯示於ARDS 早期( 即早於14 天) 使用長期低劑量類固醇可以降低死亡率。而2017 年Society ofCritical Care Medicine 和European Society of Intensive Care Medicine 建議可以在ARDS 使用類固醇。雖如是建議，臨床醫師應該小心挑選病人族群和時機，避免使用藥物後可能帶來的副作用及併發症。

Acute respiratory distress syndrome (ARDS) has been described for more than 50 years. Many treatment strategies were proven to reduce mortality. However, general prognosis was still poor. The use of corticosteroid in ARDS is controversial and clinicians have debates about its use. In this article, we would review some literatures and discuss its role in ARDS. Small group of patients in a number of clinical trials had proven to improve mortality in early ARDS. Guidelines published by Society of Critical Care Medicine and European Society of Intensive Care Medicine in 2017, suggested using corticosteroid in early treatment moderate severe ARDS. Clinicians should select the patient group and timing carefully to avoid the possible side effects and comorbidity of corticosteroid as reference above. In addition, corticosteroid should be avoided in influenza because it would increase mortality risk.