The therapeutic benefit of prolonged glucocorticoid therapy during the fibroproliferative stage of ARDS emphasizes the need for the elucidation of the underlying lung pathologies [6] . Additionally, the specific diseases such as BOOP, drug reaction, DAH and HP can cause an ARDS response to steroid therapy. However, inappropriate steroid therapy for patients with ARDS may be associated with complications such as gastrointestinal bleeding, hyperglycemia and increased susceptibility to infection.