Abstract
Background Management of Acute Respiratory Distress Syndrome is a very challenging critical illness in ICU with high morbidity and mortality worldwide.The review was intended to provide evidence on the effectiveness of Glucocorticoid treatment for acute respiratory distress syndrome Method A comprehensive search strategy was conducted on PubMed/Medline, Cochrane Library, Science direct, LILACS, and African Online Journal. Data extraction was carried out with two independent authors with customized checklist. The quality of each systemic review was assessed by two independent authors using AMSTAR tool and the overall quality of evidence was generated with online GRADEpro GDT software for primary and secondary outcomes. Result The umbrella review included nine systemic reviews and meta-analysis and one narrative review with eight thousand four hundred ninety one participants. The methodological quality of the included studies was moderate to high quality. The overall quality of evidence and recommendation varied form high to very low. Conclusion There is high to moderate quality evidence on the initiation of early low dose prolonged glucocorticoid for reduction of mortality for ARDS. However, randomized controlled trials with large sample sizes to address ventilator-free days, the incidence of infection and other glucocorticoid associated adverse events is required as the quality of evidence with these secondary outcomes were low to very low