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

Corticosteroid use and mortality of severe community-acquired pneumonia in children: A propensity score-matched analysis

“…Interestingly, recent studies in adult patients with septic shock have shown that corticosteroid use was associated with a reduced mortality rate in those with concomitant CAP, whereas no such benefit was observed in those without CAP. 15,33 Our findings are consistent with these adult studies and warrant further research to evaluate the effectiveness of corticosteroids in patients with both CAP and cardiovascular compromise, particularly in pediatric populations where corticosteroids are commonly used, despite limited evidence. 34…”

Corticosteroid use and mortality of severe community-acquired pneumonia in children: A propensity score-matched analysis

“…Interestingly, recent studies in adult patients with septic shock have shown that corticosteroid use was associated with a reduced mortality rate in those with concomitant CAP, whereas no such benefit was observed in those without CAP. 15,33 Our findings are consistent with these adult studies and warrant further research to evaluate the effectiveness of corticosteroids in patients with both CAP and cardiovascular compromise, particularly in pediatric populations where corticosteroids are commonly used, despite limited evidence. 34…”

Concomitant use of dexamethasone and tetracyclines: a potential therapeutic option for the management of severe COVID-19 infection?

“…Although direct evidence from COVID-19 patients is lacking, corticosteroids when used in critically ill sepsis patients have been shown to increase the risk of hypernatremia (RR-1.64; 95%CI −1.32–2.03), hyperglycemia (RR-1.16; 95%CI-1.08–1.24), and neuromuscular weakness (RR-1.21; 95% CI-1.01–1.52) [ 58 ]. Similar findings have been reported by Annane et al who conducted and reported a Cochrane systematic review to evaluate the effects of corticosteroids on treatment outcomes in pediatric and adult patients with sepsis [ 59 ].…”

Promises and challenges of personalized medicine to guide ARDS therapy

“…The variability in patients’ response to corticosteroids or IL-6 receptor antagonists may partly be explained by the variability in patients’ immune responses to SARS-CoV-2 [ 49 ], demonstrating that while investigating ARDS due to a common risk factor is an important strategy, it does not guarantee homogeneous response. The heterogeneity in COVID-19 patients’ responses to corticosteroids is in line with previous observations in non-COVID ARDS (Table 2 ) [ 50 , 51 ]. Preventing the unsafe exposure of individuals to immunomodulating drugs such as corticosteroids and anti-cytokine monoclonal antibodies is of the utmost importance.…”

Corticosteroid use and mortality of severe community-acquired pneumonia in children: A propensity score-matched analysis

“…Interestingly, recent studies in adult patients with septic shock have shown that corticosteroid use was associated with a reduced mortality rate in those with concomitant CAP, whereas no such benefit was observed in those without CAP. 15,33 Our findings are consistent with these adult studies and warrant further research to evaluate the effectiveness of corticosteroids in patients with both CAP and cardiovascular compromise, particularly in pediatric populations where corticosteroids are commonly used, despite limited evidence. 34…”

Concomitant use of dexamethasone and tetracyclines: a potential therapeutic option for the management of severe COVID-19 infection?

“…Although direct evidence from COVID-19 patients is lacking, corticosteroids when used in critically ill sepsis patients have been shown to increase the risk of hypernatremia (RR-1.64; 95%CI −1.32–2.03), hyperglycemia (RR-1.16; 95%CI-1.08–1.24), and neuromuscular weakness (RR-1.21; 95% CI-1.01–1.52) [ 58 ]. Similar findings have been reported by Annane et al who conducted and reported a Cochrane systematic review to evaluate the effects of corticosteroids on treatment outcomes in pediatric and adult patients with sepsis [ 59 ].…”

Promises and challenges of personalized medicine to guide ARDS therapy

“…The variability in patients’ response to corticosteroids or IL-6 receptor antagonists may partly be explained by the variability in patients’ immune responses to SARS-CoV-2 [ 49 ], demonstrating that while investigating ARDS due to a common risk factor is an important strategy, it does not guarantee homogeneous response. The heterogeneity in COVID-19 patients’ responses to corticosteroids is in line with previous observations in non-COVID ARDS (Table 2 ) [ 50 , 51 ]. Preventing the unsafe exposure of individuals to immunomodulating drugs such as corticosteroids and anti-cytokine monoclonal antibodies is of the utmost importance.…”

Corticosteroid use and mortality of severe community-acquired pneumonia in children: A propensity score-matched analysis

“…Interestingly, recent studies in adult patients with septic shock have shown that corticosteroid use was associated with a reduced mortality rate in those with concomitant CAP, whereas no such benefit was observed in those without CAP. 15,33 Our findings are consistent with these adult studies and warrant further research to evaluate the effectiveness of corticosteroids in patients with both CAP and cardiovascular compromise, particularly in pediatric populations where corticosteroids are commonly used, despite limited evidence. 34…”

Concomitant use of dexamethasone and tetracyclines: a potential therapeutic option for the management of severe COVID-19 infection?

“…Although direct evidence from COVID-19 patients is lacking, corticosteroids when used in critically ill sepsis patients have been shown to increase the risk of hypernatremia (RR-1.64; 95%CI −1.32–2.03), hyperglycemia (RR-1.16; 95%CI-1.08–1.24), and neuromuscular weakness (RR-1.21; 95% CI-1.01–1.52) [ 58 ]. Similar findings have been reported by Annane et al who conducted and reported a Cochrane systematic review to evaluate the effects of corticosteroids on treatment outcomes in pediatric and adult patients with sepsis [ 59 ].…”

Promises and challenges of personalized medicine to guide ARDS therapy

“…The variability in patients’ response to corticosteroids or IL-6 receptor antagonists may partly be explained by the variability in patients’ immune responses to SARS-CoV-2 [ 49 ], demonstrating that while investigating ARDS due to a common risk factor is an important strategy, it does not guarantee homogeneous response. The heterogeneity in COVID-19 patients’ responses to corticosteroids is in line with previous observations in non-COVID ARDS (Table 2 ) [ 50 , 51 ]. Preventing the unsafe exposure of individuals to immunomodulating drugs such as corticosteroids and anti-cytokine monoclonal antibodies is of the utmost importance.…”