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Therapy: Corticosteroid Therapy

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Total 30301 results found since Jan 2013.

Early Use of Adjunctive Therapies for Pediatric Acute Respiratory Distress Syndrome: A PARDIE Study.
CONCLUSIONS: The contemporary description of prevalence, combinations of therapies and oxygenation threshold for which the therapies are applied is important for design of future studies. Region of the world, income and comorbidities influence adjunctive therapy use and are important variables to include in PARDS investigations. PMID: 32130867 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - March 3, 2020 Category: Respiratory Medicine Authors: Rowan CM, Klein MJ, Hsing DD, Dahmer MK, Spinella PC, Emeriaud G, Hassinger AB, Piñeres-Olave BE, Flori HR, Haileselassie B, Lopez-Fernandez YM, Chima RS, Shein SL, Maddux AB, Lillie J, Kneyber MCJ, Smith LS, Khemani RG, Thomas NJ, Yehya N, Pediatric Acu Tags: Am J Respir Crit Care Med Source Type: research

Pediatric Sepsis: Challenges and Adjunctive Therapies
Sepsis remains an important challenge in pediatric critical care medicine. This review provides an appraisal of adjunctive therapies for sepsis and highlights opportunities for meeting selected challenges in the field. Future clinical studies should address long-term and functional outcomes as well as acute outcomes. Potential adjunctive therapies such as corticosteroids, hemofiltration, hemoadsorption, and plasmapheresis may have important roles, but still require formal and more rigorous testing by way of clinical trials. Finally, the design of future clinical trials should consider novel approaches for stratifying outco...
Source: Critical Care Clinics - January 4, 2013 Category: Intensive Care Authors: William Hanna, Hector R. Wong Source Type: research

Longer RBC Storage Duration Is Associated With Increased Postoperative Infections in Pediatric Cardiac Surgery
Discussion: Longer RBC storage duration was associated with increased postoperative nosocomial infections. This association may be secondary in part, to the large doses of stored RBCs transfused, from single-donor units. Washing the oldest RBCs was associated with increased morbidity, possibly from increased destruction of older, more fragile erythrocytes incurred by washing procedures. Additional studies examining the effect of RBC storage age on postoperative infection rate in pediatric cardiac surgery are warranted.
Source: Pediatric Critical Care Medicine - March 1, 2015 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

A prospective study of fungal colonization and invasive fungal disease in long-term mechanically ventilated patients in a respiratory intensive care unit
Conclusion: Long-term mechanical ventilation (>7 days) is strongly associated with fungal colonization of the respiratory tract and urinary tract. Appropriate prophylactic antifungals may be given and infection control practices to be observed to ensure minimum colonization and therefore infection in such settings.
Source: Indian Journal of Critical Care Medicine - August 17, 2018 Category: Intensive Care Authors: Amartya Chakraborti Anand Jaiswal Pushpendra Kumar Verma Ritu Singhal Source Type: research

Predictors of mortality and length of stay in hospitalized cases of 2009 influenza A (H1N1): Experiences of a tertiary care center
Conclusion: Increased duration of dyspnoea prior to admission, pneumonia, low PaO 2 /FiO 2 ratio at admission and 24 hours later, higher PaCO 2 values on admission, higher O 2 requirement, number of organ failures and use of corticosteroids and delay in specialized treatment were associated with a poorer outcome.
Source: Indian Journal of Critical Care Medicine - October 24, 2013 Category: Intensive Care Authors: Rajesh ChawlaSudha KansalMunish ChauhanAshish JainBipin Narayanrao Jibhkate Source Type: research

Early Hydrocortisone Replacement After Septic ShockEarly Hydrocortisone Replacement After Septic Shock
Timing of corticosteroid dosing may have a critical impact on outcomes in patients with septic shock. Critical Care Medicine
Source: Medscape Critical Care Headlines - July 8, 2014 Category: Intensive Care Tags: Critical Care Journal Article Source Type: news

A Survey of Attitudes and Practices Regarding the Use of Steroid Supplementation in Pediatric Sepsis
Conclusions: Corticosteroids are used at most centers for treatment of PSS, but significant variation in attitudes and use exists. Most centers identify AI as frequent; most report variable use of stimulation testing and dosing of CSs. Few centers currently use a standard protocol for diagnosis and treatment. Interest in performing a randomized trial for CSs remains because in part of reluctance to accept adult trial data.
Source: Pediatric Emergency Care - October 1, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Critical Update on the Third Edition of the Guidelines for Managing Severe Traumatic Brain Injury in Children.
CONCLUSIONS: The evidence base for treating pediatric TBI is increasing and provides the basis for high-quality care. This article provides critical care providers with a quick reference to the current evidence when caring for a child with a severe TBI. In addition, it provides direct access links to the comprehensive guideline document and algorithms developed to support critical care providers. PMID: 31968082 [PubMed - in process]
Source: American Journal of Critical Care - December 31, 2019 Category: Nursing Authors: Reuter-Rice K, Christoferson E Tags: Am J Crit Care Source Type: research

Correction to: Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017
AbstractTo update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients
Source: Intensive Care Medicine - February 23, 2018 Category: Intensive Care Source Type: research

Corticosteroids are associated with repression of adaptive immunity gene programs in pediatric septic shock.
Conclusions: Administration of corticosteroids in pediatric septic shock is associated with additional repression of genes corresponding to adaptive immunity. These data should be taken into account when considering the benefit to risk ratio of adjunctive corticosteroids for septic shock. PMID: 24650276 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - March 20, 2014 Category: Respiratory Medicine Authors: Wong HR, Cvijanovich NZ, Allen GL, Thomas NJ, Freishtat RJ, Anas N, Meyer K, Checchia PA, Weiss SL, Shanley TP, Bigham MT, Banschbach S, Beckman E, Harmon K, Zimmerman JJ Tags: Am J Respir Crit Care Med Source Type: research

Dynamics and prognostic value of the hypothalamus –pituitary–adrenal axis responses to pediatric critical illness and association with corticosteroid treatment: a prospective observational study
ConclusionIn critically ill children, systemic cortisol availability is elevated only transiently, much lower than in adults, and not driven by elevated ACTH. Further ACTH lowering by corticosteroid-treatment indicates active feedback inhibition at pituitary level. Beyond PICU-admission-day, low ACTH and high cortisol, and corticosteroid-treatment, predicted poor outcome. This suggests that exogenously increasing cortisol availability during acute critical illness in children may be inappropriate. Future studies on corticosteroid-treatment in critically ill children should plan safety analyses, as harm may be possible.
Source: Intensive Care Medicine - November 10, 2019 Category: Intensive Care Source Type: research

An Epidemiologic Survey of Pediatric Sepsis in Regional Hospitals in China*
Conclusions: We first report the prevalence and outcome of pediatric sepsis based on a regional hospital network in China. The diverse treatment approaches and practice at low-level clinics suggest the need for clinical implementation of internationally recognized strategy to improve the care standard in resource-limited regional hospitals.
Source: Pediatric Critical Care Medicine - November 1, 2014 Category: Pediatrics Tags: Feature Articles Source Type: research

An International Survey of Corticosteroid Use for the Management of Low Cardiac Output Syndrome*
Conclusions: Our survey demonstrates considerable practice variability with regard to the type of patients in whom corticosteroids are administered, adrenal axis testing is performed, and dosage of hydrocortisone used. The majority of physicians, however, stated their willingness to randomize patients with severe low cardiac output syndrome in a corticosteroids trial. This survey identified multiple areas for future research on use of corticosteroids for low cardiac output syndrome.
Source: Pediatric Critical Care Medicine - July 1, 2017 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Corticosteroids in Pediatric Shock: A Call to Arms*
Conclusions: We strongly believe that the time has come to conduct a trial on the use of corticosteroids in pediatric septic shock and that the question to be answered is Will corticosteroids given to children with septic shock result in a benefit to some patients without resulting in harm to others? Answering this question will require a collaborative and committed effort on the parts of ethics boards, families, clinicians, and researchers to actually make it happen once and for all, and we propose an international planning meeting of interested parties to achieve agreement on these identified issues.
Source: Pediatric Critical Care Medicine - October 1, 2015 Category: Pediatrics Tags: Online PCCM Perspectives Source Type: research

Epidemiology of Pediatric Severe Sepsis in Main PICU Centers in Southwest China*
Conclusions: This report is the first to present the prevalence, treatment, and outcomes of pediatric severe sepsis in the main PICU centers in Southwest China. The mortality rate remains high; therefore, improved clinical management and implementation of large-scale clinical trials are necessary to improve early diagnoses and treatment.
Source: Pediatric Critical Care Medicine - December 1, 2019 Category: Pediatrics Tags: Feature Articles Source Type: research