Corticosteroids for treating sepsis in children and adults

Annane, Djillali; Bellissant, Éric; Bollaert, Pierre Edouard; Briegel, Josef; Keh, Didier; Kupfer, Yizhak; Pirracchio, Romain; Rochwerg, Bram

doi:10.1002/14651858.cd002243.pub4

Cited by 93 publications

(109 citation statements)

References 157 publications

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Section: Discussionmentioning

confidence: 99%

“…Corticosteroids is commonly used for treating sepsis [20,21]. The results of previous studies showed a mild increase in sodium level and increased the risk of hypernatremia with high-certainty evidence [20][21][22][23]. It is suggested that administration of corticosteroids is associated with reduced 28day mortality compared with placebo use or standard supportive care [22].…”

Section: Discussionmentioning

confidence: 99%

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Predictive Role of Hypernatremia for Acute Kidney Injury in Patients with Sepsis

Zhi

Lin

Dong

et al. 2019

Preprint

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Introduction Septic acute kidney injury (AKI), identified when both sepsis and AKI present, is a syndrome of acute function impairment and organ damage, accounting for ~50% AKI in ICU (Intensive Care Unit)Method This study retrospectively reviewed 591 patients who were diagnosed of sepsis and admitted to the ICU of Beijing Friendship Hospital from January 2009 to December 2014. According to the concentration of serum sodium, the 591 patients were further divided into three groups: normal group, hyponatremia group and hypernatremia group.Result PaCO 2 (P=0.014), concentration of Na + (P<0.001) and Cl - (P<0.001), BUN (P<0.001), APACHE score (P<0.001), SOFA score (P<0.001) and Glasgow score (P<0.001) showed significant differences. CK (P=0.012; OR=1.000), BUN (P=0.002; OR=1.047), Cl - (P<0.001;OR=1.255), lactic acid (P=0.001;OR=1.244), and HCO 3 - (P<0.001;OR=1.180) may be risk factors for hypernatremia in patients with sepsis. APACHE score (P=0.028;OR=1.222) and CK (P=0.014;or=1.003) may be risk factors for AKI in patients with hypernatremia. Na + suggested a good predictive ability for AKI (P<0.001; AUC: 0.586) but not for death (P=0.104)Conclusion Hypernatremia is independently associated with an increased risk and has a predictive ability of AKI in patients with sepsis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictive Role of Hypernatremia for Acute Kidney Injury in Patients with Sepsis

Zhi

Lin

Dong

et al. 2019

Preprint

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“…Corticosteroids produced by adrenocortical cells and their synthetic analogues have multiple biological effects, including immune modulation (78,79). Several clinical trials conducted over the years provided discordant results (80)(81)(82)(83). Among them, ADRENAL stands as one of the largest RCTs (n = 3800), which showed that hydrocortisone did not decrease mortality in septic shock patients who needed mechanical ventilation (83).…”

Section: Painful and Inspiring Lessons From Sepsis For Covid-19 Immunmentioning

confidence: 99%

“…Among them, ADRENAL stands as one of the largest RCTs (n = 3800), which showed that hydrocortisone did not decrease mortality in septic shock patients who needed mechanical ventilation (83). Nevertheless, a very (80). There is also some renewed interest in the combination of hydrocortisone, ascorbic acid, and thiamine for the treatment of sepsis, with the establishment of several RCTs, such as the ACTS trial (NCT03389555) (84).…”

Section: Painful and Inspiring Lessons From Sepsis For Covid-19 Immunmentioning

confidence: 99%

Immune Response Resetting as a Novel Strategy to Overcome SARS-CoV-2–Induced Cytokine Storm

Nowill

Campos-Lima

2020

The Journal of Immunology

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which rapidly became a pandemic of global proportions. Sepsis is commonly present with high lethality in the severe forms of the disease. The virus-induced cytokine storm puts the immune system in overdrive at the expense of the pathogen-specific immune response and is likely to underlie the most advanced COVID-19 clinical features, including sepsis-related multiple organ dysfunction as well as the pathophysiological changes found in the lungs. We review the major therapeutic strategies that have been considered for sepsis and might be amenable to repurposing for COVID-19. We also discuss two different immunization strategies that have the potential to confer antiviral heterologous protection: innate-induced trained immunity and adaptive-induced immune response resetting.

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“…The discipline of paediatric neurology encompasses diseases and disorders of the brain, spinal cord, peripheral nervous system, autonomic system, muscle and blood vessels that effects individual in this age group. Over the past two decades, high-dose of corticosteroids therapy (an approach already used to treat several neurological syndromes such as multiple sclerosis) has been used in various studies in the eld of epilepsy in order to avoid the development of adverse effects and maintained long term e cacy [1][2][3][4]. In the USA in 2019, corticosteroids were the most common speci c cause for drug-related adverse effects, accounting for 10.3% of all drug related adverse effects and 141,000 hospital stays [5].…”

Section: Introductionmentioning

confidence: 99%

Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy

Perera¹,

Samarasekara²,

Shiwanth³

et al. 2020

Preprint

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Background: Corticosteroids are potent medications used to treat in many inflammatory conditions in paediatric neurology practice. Although corticosteroids are beneficial, their adverse effects may be numerous and vary. As parents are the primary caregivers of paediatric patients, assessing their awareness is timely important. Methods: To determine the parental awareness on adverse effects of corticosteroid therapy in Paediatric Neurology Patients in the Neurology Unit at the Lady Ridgeway Hospital, Colombo, Sri Lanka. In this descriptive cross-sectional study, 300 parents of paediatric neurology patients on long-term corticosteroid therapy in the paediatric neurology unit were included. Parents were volunteered for the study and signed informed consent. Ethical approval was obtained from the Ethics Review Committee of the same hospital. Data were collected using content validated, pre-tested self-administered questionnaire during January to March 2020. Results: Of the total parents, the majority were mothers (87%, n=262) and more than 70% (n=211) of them completed their secondary education. Findings demonstrated that parents had average awareness about adverse effects of long-term steroid therapy including child’s susceptibility to infections (69.0%, n=207), increase blood glucose levels (69.7%, n=209), moon face (60.3%. n=181), central obesity (60.3%, n=181), increase blood pressure levels (58.0%, n=174) and (irritability 50.3%, n=151) while poor awareness on adverse effects include buffalo humps (26.7%, n=80) increase fracture tendency (24.3%, n=73), tarry colour stools (24.3%, n=73), vision impairment (24.0%, n=72), glaucoma (17.3%, n=52), cataract (16.0%, n=48 ) and delayed wound healing (23.0%, n=69). According to the findings, overall mean (SD) knowledge percentage on parental awareness of adverse effects was found to be low (38.24 ± 20.57). Conclusion: Since parental awareness of the adverse effects of long-term corticosteroid therapy is inconsistent, special attention is needed to plan and implement appropriate awareness sessions.

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Corticosteroids for treating sepsis in children and adults

Abstract: Analysis 2.5. Comparison 2 Continuous infusion versus bolus administration of corticosteroids, Outcome 5 Hospital mortality.... Analysis 2.6. Comparison 2 Continuous infusion versus bolus administration of corticosteroids, Outcome

Cited by 93 publications

References 157 publications

Predictive Role of Hypernatremia for Acute Kidney Injury in Patients with Sepsis

Predictive Role of Hypernatremia for Acute Kidney Injury in Patients with Sepsis

Immune Response Resetting as a Novel Strategy to Overcome SARS-CoV-2–Induced Cytokine Storm

Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy

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