2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia-Reference-Cited by-同舟云学术

2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia

Published:2024-01-19 Issue: Volume: Page:
ISSN:0090-3493
Container-title:Critical Care Medicine
language:en
Short-container-title:

Author:

Chaudhuri Dipayan¹²,Nei Andrea M.³,Rochwerg Bram¹²,Balk Robert A⁴,Asehnoune Karim⁵,Cadena Rhonda⁶,Carcillo Joseph A.⁷,Correa Ricardo⁸,Drover Katherine⁹,Esper Annette M.¹⁰,Gershengorn Hayley B.¹¹¹²,Hammond Naomi E.¹³¹⁴,Jayaprakash Namita¹⁵¹⁶,Menon Kusum¹⁷¹⁸,Nazer Lama¹⁹,Pitre Tyler¹²,Qasim Zaffer A.²⁰,Russell James A.²¹,Santos Ariel P.²²,Sarwal Aarti²³,Spencer-Segal Joanna²⁴,Tilouche Nejla²⁵,Annane Djillali²⁶²⁷²⁸,Pastores Stephen M.²⁹

Affiliation:

1. Department of Medicine, McMaster University, Hamilton, ON, Canada.

2. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

3. Department of Pharmacy, Mayo Clinic Hospital—Rochester, Rochester, MN.

4. Department of Internal Medicine, Rush University Medical Center, Chicago, IL.

5. Department of Anesthesiology, CHU Nantes, Université de Nantes, Pôle Anesthésie-Réanimation, Service d’Anesthésie Réanimation Chirurgicale, Hôtel Dieu, Nantes, France.

6. Department of Internal Medicine, Wake Forest School of Medicine, Atrium Health, Carolinas Medical Center, Charlotte, NC.

7. Department of Critical Care Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA.

8. Department of Endocrinology, Diabetes and Metabolism, Endocrine and Metabolism Institute, Cleveland Clinic, Cleveland, OH.

9. McMaster University, Hamilton, ON, Canada.

10. Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA.

11. Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine; Miami, FL.

12. Division of Critical Care Medicine, Albert Einstein College of Medicine, Bronx, NY.

13. Malcolm Fisher Department of Intensive Care Medicine, Critical Care Program, The George Institute for Global Health, UNSW Sydney, Newtown, NSW, Australia.

14. Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia.

15. Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI.

16. Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI.

17. Division of Pediatric Critical Care, University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.

18. Department of Pediatrics, University of Ottawa and Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.

19. King Hussein Cancer Center Department of Pharmacy, Amman, Jordan.

20. Department of Emergency Medicine and Critical Care Medicine, University of Pennsylvania Health System, Philadelphia, PA.

21. Division of Critical Care, Department of Medicine, Centre for Heart Lung Innovation St. Paul’s Hospital University of British Columbia, Vancouver, BC, Canada.

22. Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX.

23. Department of Neurology [Neurocritical Care], Atrium Wake Forest School of Medicine, Winston Salem, NC.

24. Department of Internal Medicine and Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI.

25. Intensive Care Unit, Service de Réanimation Polyvalente, Hôpital de Gonesse, Gonesse, France.

26. Department of Intensive Care, Raymond Poincaré Hospital, Assistance Publique-Hôpitaux de Paris, Garches, France.

27. School of Medicine Simone Veil, University of Versailles Saint Quentin, University Paris-Saclay, Versaillles, France.

28. IHU Prometheus Fédération Hospitalo-Universitaire SEPSIS, University Paris-Saclay, INSERM, Garches, France.

29. Department of Anesthesiology and Critical Care Medicine, Critical Care Center, Memorial Sloan Kettering Cancer Center, New York, NY.

Abstract

Rationale: New evidence is available examining the use of corticosteroids in sepsis, acute respiratory distress syndrome (ARDS) and community-acquired pneumonia (CAP), warranting a focused update of the 2017 guideline on critical illness-related corticosteroid insufficiency. Objectives: To develop evidence-based recommendations for use of corticosteroids in hospitalized adults and children with sepsis, ARDS, and CAP. Panel Design: The 22-member panel included diverse representation from medicine, including adult and pediatric intensivists, pulmonologists, endocrinologists, nurses, pharmacists, and clinician-methodologists with expertise in developing evidence-based Clinical Practice Guidelines. We followed Society of Critical Care Medicine conflict of interest policies in all phases of the guideline development, including task force selection and voting. Methods: After development of five focused Population, Intervention, Control, and Outcomes (PICO) questions, we conducted systematic reviews to identify the best available evidence addressing each question. We evaluated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach and formulated recommendations using the evidence-to-decision framework. Results: In response to the five PICOs, the panel issued four recommendations addressing the use of corticosteroids in patients with sepsis, ARDS, and CAP. These included a conditional recommendation to administer corticosteroids for patients with septic shock and critically ill patients with ARDS and a strong recommendation for use in hospitalized patients with severe CAP. The panel also recommended against high dose/short duration administration of corticosteroids for septic shock. In response to the final PICO regarding type of corticosteroid molecule in ARDS, the panel was unable to provide specific recommendations addressing corticosteroid molecule, dose, and duration of therapy, based on currently available evidence. Conclusions: The panel provided updated recommendations based on current evidence to inform clinicians, patients, and other stakeholders on the use of corticosteroids for sepsis, ARDS, and CAP.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Critical Care and Intensive Care Medicine

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