SCCM Resource Library-Corticosteroids in Sepsis: Why, Who, and How Much?

Video Transcription

Video Summary

Dr. Natalie Cvjanovic, a pediatric intensivist at UCSF Benioff Children's Hospital, discusses the use of corticosteroids in sepsis. While corticosteroids have been shown to have short-term hemodynamic benefits, there is controversy surrounding their use in septic shock. Corticosteroid insufficiency, or SIRSI, is a condition where there is inadequate corticosteroid activity relative to the severity of the patient's critical illness. The principle behind steroid supplementation in septic shock is to restore balance in the host response. However, determining who would benefit from steroids is challenging due to the lack of reliable diagnostic criteria for SIRSI. There are also risks associated with the administration of steroids, and some subpopulations of patients with septic shock may experience harm. Current guidelines recommend steroid use in adults with sepsis, but the recommendation is weaker for children. Prognostic and predictive enrichment strategies, based on biomarkers and gene expression patterns, can help refine treatment strategies and identify patients who may benefit the most from corticosteroids. Ongoing trials are studying the effectiveness of steroids in pediatric and adult septic shock patients.

Asset Subtitle

Pharmacology, Sepsis, 2022

Asset Caption

Corticosteroids are commonly used and frequently debated in critical illness settings. This session will review our basic understanding of the range of corticosteroid effects pertinent to critical illness and will summarize evidence for the utility of corticosteroids for two common ICU syndromes: acute respiratory distress syndrome and sepsis.

Meta Tag

Content Type Presentation

Knowledge Area Pharmacology

Knowledge Area Sepsis

Knowledge Level Intermediate

Knowledge Level Advanced

Learning Pathway Sepsis Resources

Membership Level Select

Tag Pharmacokinetics Pharmacodynamics

Tag Sepsis

Year 2022

Keywords

corticosteroids

sepsis

septic shock

steroid supplementation

diagnostic criteria

Pharmacology

Pharmacokinetics Pharmacodynamics

Presentation

Select

2022

Intermediate

Advanced

Sepsis Resources

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