NEW PARADIGMS OF ANABOLIC STEROID USE IN CRITICAL PATIENTS IN THE INTENSIVE CARE UNIT: A LITERATURE REVIEW

Abstract

The Intensive Care Unit (ICU) is a challenging environment where critically ill patients require advanced support. In this context, complications include extreme hypercatabolic state, rapid loss of muscle mass, functional impairment and systemic dysfunction. Anabolic-androgenic steroids (AAS) emerge as a complementary therapy to preserve muscle mass and improve functional recovery, mitigating the effects of sarcopenia in critical states. The study explores the evidence on AAS, their benefits and risks, and new directions for their use in intensive care. This is a retrospective review in the PubMed, Scopus and Embase databases, using related descriptors and applying the Boolean operator “AND”. The exclusion criteria included articles not relevant to the topic and publications outside the period 2004 to 2024. The findings highlight the need to balance the benefits and risks of AAS, careful patient selection and continuous monitoring as fundamental pieces to ensure effective results. The efficacy of steroids is linked to the preservation of muscle mass and the acceleration of recovery in severe catabolic states. Thus, the use of AAS in critically ill patients can improve functional recovery and reduce morbidity and mortality related to muscle loss in ICUs, however, it should be evaluated cautiously and on an individual basis. New approaches advocate selective agents associated with personalized treatment, aiming to make their use safer and more effective, and further research is still needed to determine their role in intensive care.The Intensive Care Unit (ICU) is a challenging environment where critically ill patients require advanced support. In this context, complications include extreme hypercatabolic state, rapid loss of muscle mass, functional impairment and systemic dysfunction. Anabolic-androgenic steroids (AAS) emerge as a complementary therapy to preserve muscle mass and improve functional recovery, mitigating the effects of sarcopenia in critical states. The study explores the evidence on AAS, their benefits and risks, and new directions for their use in intensive care. This is a retrospective review in the PubMed, Scopus and Embase databases, using related descriptors and applying the Boolean operator “AND”. The exclusion criteria included articles not relevant to the topic and publications outside the period 2004 to 2024. The findings highlight the need to balance the benefits and risks of AAS, careful patient selection and continuous monitoring as fundamental pieces to ensure effective results. The efficacy of steroids is linked to the preservation of muscle mass and the acceleration of recovery in severe catabolic states. Thus, the use of AAS in critically ill patients can improve functional recovery and reduce morbidity and mortality related to muscle loss in ICUs, however, it should be evaluated cautiously and on an individual basis. New approaches advocate selective agents associated with personalized treatment, aiming to make their use safer and more effective, and further research is still needed to determine their role in intensive care.