Conference Coverage

Critical illness-related corticosteroid insufficiency guidelines explained


 

EXPERT ANALYSIS FROM THE CCC47


“There were a lot of back and forth disagreements behind these recommendations,” said Dr. Pastores, who is the director of the critical care medicine fellowship training and research programs at Memorial Sloan Kettering Cancer Center, New York. “We only required 80% of the panelists to agree that these were the recommendations and statements that we were going to go by.”

The guidelines recommend against the use of corticosteroids in adult patients who have sepsis without shock, Dr. Pastores noted.

In contrast, the guidelines do suggest using corticosteroids for hospitalized adults patients with septic shock that is not responsive to fluid and moderate- to high-dose vasopressor therapy.

In an analysis of available data from randomized clinical trials including patients with septic shock, corticosteroids significantly reduced 28-day mortality when compared with placebo, Dr. Pastores said.

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