Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-12c

12c_Steroid Guideline

Pdf Summary

The document provides a focused update on the use of corticosteroids in sepsis, acute respiratory distress syndrome (ARDS), and community-acquired pneumonia (CAP) as of 2024. The recommendations for corticosteroid use in sepsis and septic shock include faster shock reversal, reduced organ dysfunction, and shorter ICU/hospital stays, with potential side effects like neuromuscular weakness and hypernatremia. In ARDS, corticosteroids may reduce 28-day mortality, shorten mechanical ventilation duration, and hospital stay. In severe CAP cases, corticosteroids show benefits in reducing hospital mortality and the need for mechanical ventilation. However, the document highlights uncertainties regarding the ideal dose, timing, and type of corticosteroids and their potential side effects like hyperglycemia and increased risk of infections. Lastly, recommendations for corticosteroid dosing in severe bacterial CAP include specific regimens with varying durations based on clinical improvement. The document calls for further well-conducted studies to provide clearer guidance on corticosteroid use in these critical conditions, emphasizing the need for clinician discretion pending more data.

Keywords

corticosteroids

sepsis

ARDS

community-acquired pneumonia

shock reversal

organ dysfunction

ICU stay

mechanical ventilation

hypernatremia

hyperglycemia

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