Villar J, Ferrando C, Martínez D, et al. - Researchers undertook this multicentre, randomized controlled trial in Spain, to test the impacts of dexamethasone in acute respiratory distress syndrome (ARDS), anticipating a reduction in duration of mechanical ventilation and mortality as a result of its use in ARDS patients. Overall 17 ICUs in teaching hospitals participated. In a random manner, the eligible patients were allocated to receive immediate therapy with dexamethasone or continued routine intensive care (control group). From day 1 to day 5, an intravenous dose of 20 mg once daily was administered to the patients in the dexamethasone group, this dose was reduced to 10 mg once daily from day 6 to day 10. The dexamethasone group vs the control group had a higher mean number of ventilator-free days. At 60 days, the deaths of 29 (21%) and 50 (36%) patients were reported in the dexamethasone group and in the control group, respectively. Overall, a decrease in the duration of mechanical ventilation, as well as overall mortality, could be brought about by early administration of dexamethasone in patients with established moderate-to-severe ARDS.