2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia
Authors: Dipayan Chaudhuri, Andrea M Nei, Bram Rochwerg, Robert A Balk, Karim Asehnoune, Rhonda Cadena, Joseph A Carcillo, Ricardo Correa, Katherine Drover, Annette M Esper, Hayley B Gershengorn, Naomi E Hammond, Namita Jayaprakash, Kusum Menon, Lama Nazer, Tyler Pitre, Zaffer A Qasim, James A Russell, Ariel P Santos, Aarti Sarwal, Joanna Spencer-Segal, Nejla Tilouche, Djillali Annane, Stephen M Pastores
Published in: Critical Care Medicine, 2024 January 20
Conclusions:
- The updated guidelines provide clinicians, patients, and stakeholders with current evidence-based recommendations on corticosteroid use for sepsis, ARDS, and CAP, aiming to improve patient outcomes through informed decision-making.
Panel Design:
- A 22-member interdisciplinary panel was formed, adhering to Society of Critical Care Medicine's conflict of interest policies.
Methods:
- Systematic reviews were conducted based on five focused Population, Intervention, Control, and Outcomes (PICO) questions, utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach for evidence assessment and recommendation formulation.
Results:
- The panel issued four key recommendations:
- Conditional recommendation for corticosteroid administration in patients with septic shock.
- Conditional recommendation for corticosteroid use in critically ill patients with ARDS.
- Strong recommendation for corticosteroid therapy in hospitalized patients with severe CAP.
- Recommendation against high dose/short duration corticosteroid treatment for septic shock.
- The panel could not provide specific guidance on the corticosteroid molecule, dose, and duration for ARDS due to limited evidence.
Chaudhuri, D., Nei, A.M., Rochwerg, B., Balk, R.A., Asehnoune, K., Cadena, R., Carcillo, J.A., Correa, R., Drover, K., Esper, A.M. and Gershengorn, H.B., 2024. 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Critical Care Medicine, pp.10-1097.