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

Autor:	Chaudhuri D; Department of Medicine, McMaster University, Hamilton, ON, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada., Nei AM; Department of Pharmacy, Mayo Clinic Hospital-Rochester, Rochester, MN., Rochwerg B; Department of Medicine, McMaster University, Hamilton, ON, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada., Balk RA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL., Asehnoune K; Department of Anesthesiology, CHU Nantes, Université de Nantes, Pôle Anesthésie-Réanimation, Service d'Anesthésie Réanimation Chirurgicale, Hôtel Dieu, Nantes, France., Cadena R; Department of Internal Medicine, Wake Forest School of Medicine, Atrium Health, Carolinas Medical Center, Charlotte, NC., Carcillo JA; Department of Critical Care Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA., Correa R; Department of Endocrinology, Diabetes and Metabolism, Endocrine and Metabolism Institute, Cleveland Clinic, Cleveland, OH., Drover K; McMaster University, Hamilton, ON, Canada., Esper AM; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA., Gershengorn HB; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine; Miami, FL.; Division of Critical Care Medicine, Albert Einstein College of Medicine, Bronx, NY., Hammond NE; Malcolm Fisher Department of Intensive Care Medicine, Critical Care Program, The George Institute for Global Health, UNSW Sydney, Newtown, NSW, Australia.; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia., Jayaprakash N; Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI.; Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI., Menon K; Division of Pediatric Critical Care, University of Ottawa and Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.; Department of Pediatrics, University of Ottawa and Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada., Nazer L; King Hussein Cancer Center Department of Pharmacy, Amman, Jordan., Pitre T; Department of Medicine, McMaster University, Hamilton, ON, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada., Qasim ZA; Department of Emergency Medicine and Critical Care Medicine, University of Pennsylvania Health System, Philadelphia, PA., Russell JA; Division of Critical Care, Department of Medicine, Centre for Heart Lung Innovation St. Paul's Hospital University of British Columbia, Vancouver, BC, Canada., Santos AP; Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX., Sarwal A; Department of Neurology [Neurocritical Care], Atrium Wake Forest School of Medicine, Winston Salem, NC., Spencer-Segal J; Department of Internal Medicine and Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI., Tilouche N; Intensive Care Unit, Service de Réanimation Polyvalente, Hôpital de Gonesse, Gonesse, France., Annane D; Department of Intensive Care, Raymond Poincaré Hospital, Assistance Publique-Hôpitaux de Paris, Garches, France.; School of Medicine Simone Veil, University of Versailles Saint Quentin, University Paris-Saclay, Versaillles, France.; IHU Prometheus Fédération Hospitalo-Universitaire SEPSIS, University Paris-Saclay, INSERM, Garches, France., Pastores SM; Department of Anesthesiology and Critical Care Medicine, Critical Care Center, Memorial Sloan Kettering Cancer Center, New York, NY.
Jazyk:	angličtina
Zdroj:	Critical care medicine [Crit Care Med] 2024 May 01; Vol. 52 (5), pp. e219-e233. Date of Electronic Publication: 2024 Jan 19.
DOI:	10.1097/CCM.0000000000006172
Abstrakt:	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. Competing Interests: Dr. Balk received funding from Dompe Pharmaceuticals, Merck, and BioMerieux. Dr. Sarwal’s institution receives funding from Biogen, Bard, Novartis, CVR Global, Lung Pacer, the National Institute on Aging (R01 AG066910-01), Shaltout, and Butterfly. Dr. Gershengorn disclosed that she served as an advisory board member for Gilead Sciences. Dr. Menon received funding from the Canadian Institutes of Health Research. Dr. Jayaprakash disclosed that she was the site principal investigator for sponsored trials through Abbott Laboratories and BioCogniV. Dr. Russell reports patents owned by the University of British Columbia (UBC) that are related to the use of PCSK9 inhibitor(s) in sepsis and related to the use of vasopressin in septic shock and a patent owned by Ferring for use of selepressin in septic shock. Dr. Russell is an inventor of these patents. Dr. Russell was a founder, Director and shareholder in Cyon Therapeutics and is a shareholder in Molecular You Corp. Dr. Russell is no longer actively consulting for any industry. Dr. Russell reports receiving consulting fees in the last 3 years from: 1) SIB Therapeutics LLC (developing a sepsis drug). 2) Ferring Pharmaceuticals (manufactures vasopressin and developing selepressin). 3) Dr. Russell was a funded member of the Data and Safety Monitoring Board of a National Institutes of Health-sponsored trial of plasma in COVID-19 (PASS-IT-ON) (2020–2021). 4) PAR Pharma (sells prepared bags of vasopressin). Dr. Russell reports having received an investigator-initiated grant from Grifols (entitled “Is HBP a mechanism of albumin’s efficacy in human septic shock?”) that was provided to and administered by UBC. Dr. Russell was a nonfunded Science Advisor and member of the Government of Canada COVID-19 Therapeutics Task Force (June 2020 to 2021). Dr. Asehnoune received funding from LFB and Edwards Lifesciences Baxter. Dr. Spencer-Segal received funding from Camurus AB, Chiasma, and Recordati Rare Diseases. Dr. Esper received funding from Honeywell. Dr. Annane has been involved with research relating to this guideline, in particular with multiple randomized control trials examining the use of corticosteroids in sepsis. He participated in the discussion for corticosteroids in sepsis but abstained from voting on final recommendations pertaining to corticosteroids in sepsis and septic shock. Dr. Menon is funded by a Canadian Institute of Health Research grant for The Stress Hydrocortisone in Pediatric Septic Shock trial. The remaining authors have disclosed that they do not have any potential conflicts of interest. 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. (Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.)
Databáze:	MEDLINE
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