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To the Editor: Dr De Jonghe and colleagues¹ concluded that "there was an important role of corticosteroids in the development of ICUAP" and recommended that corticosteroid administration be limited to patients who have indications based on evidence-based indications. Although we agree that corticosteroids, like any other intervention, should be limited to patients who have a proven benefit, it is difficult to find a causal relationship between paresis and corticosteroid use in their study. The control and case patients received corticosteroids for a similar number of days, and the control group actually received a higher total dose of corticosteroids.

Overall, the case group was sicker. They were also older, had higher admission Simplified Acute Physiology Score 2 scores, higher admission organ dysfunction and/or infection scores, had a greater propensity for sepsis, and were more likely to have a prolonged course of multiple organ dysfunction. Corticosteroids are often used in late sepsis, . . . [Full Text of this Article]

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