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Therapy: Corticosteroid Therapy

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Making Decisions About Medications in Critically Ill Children: A Survey of Canadian Pediatric Critical Care Clinicians
Conclusions: The relative importance of many factors that clinicians consider when making decisions about medications varies by demographics, and depends on the clinical problem. This variability should be considered in quality improvement and knowledge translation interventions in this setting.
Source: Pediatric Critical Care Medicine - January 1, 2015 Category: Pediatrics Tags: Feature Articles Source Type: research

SCCM Pod-148 Adjunctive Corticosteroid Therapy in Pediatric Sepsis
Jerry J. Zimmerman, MD, PhD, FCCM, discusses his article published in the January Pediatric Critical Care Medicine
Source: SCCM PodCast - iCritical Care - April 7, 2011 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts

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
Objective: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. Participants: A multispecialty task force of 16 international experts in critical care medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. Design/Methods: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies f...
Source: Critical Care Medicine - November 18, 2017 Category: Emergency Medicine Tags: Special Articles Source Type: research

Critical Illness-Related Corticosteroid Insufficiency (CIRCI): A Narrative Review from a Multispecialty Task Force of the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM)
Conclusions: Novel insights into the pathophysiology of CIRCI add to the limitations of the current diagnostic tools to identify at-risk patients and may also impact how corticosteroids are used in patients with CIRCI.
Source: Critical Care Medicine - November 18, 2017 Category: Emergency Medicine Tags: Special Articles Source Type: research

2016 Update for the Rogers’ Textbook of Pediatric Intensive Care: Recognition and Initial Management of Shock
Conclusion: Research efforts in pediatric shock have largely centered on pediatric septic shock, with significant progress in the understanding of sepsis epidemiology, the use of extracorporeal therapies in critically ill children with sepsis, the role of hyperlactatemia and risk stratification in pediatric septic shock, and the impact of bundled care for pediatric sepsis, including evaluation of individual bundle elements such as the optimal timing of antibiotic administration and vasoactive medication choice. A consistent theme in the literature is the beneficial role of a bundled approach to septic shock recognition and...
Source: Pediatric Critical Care Medicine - November 1, 2016 Category: Pediatrics Tags: Rogers' Update Source Type: research

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
ConclusionsEvidence-based recommendations for the use of corticosteroids in critically ill patients with sepsis and septic shock, acute respiratory distress syndrome, and major trauma have been developed by a multispecialty task force.
Source: Intensive Care Medicine - September 21, 2017 Category: Intensive Care Source Type: research

Measurement of Salivary Cortisol Level for the Diagnosis of Critical Illness–Related Corticosteroid Insufficiency in Children*
Objective: To compare serum total, serum free and salivary cortisol in critically ill children. Design: Prospective observational cohort study. Setting: Tertiary pediatric critical care unit at Ronald McDonald Children’s Hospital at Loyola University Medical Center. Patients: We enrolled 59 patients (4 weeks to 18 years of age) between January 2012 and May 2013. Thirty-four patients were included in the salivary to serum free cortisol correlational analysis. Interventions: Blood and saliva samples were obtained simultaneously within 24 hours of admission between the hours of 6 AM and 12 PM. Salivary cortisol was tested b...
Source: Pediatric Critical Care Medicine - May 1, 2015 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Global Epidemiology of Pediatric Severe Sepsis: the Sepsis PRevalence, OUtcomes, and Therapies Study.
Conclusions: Pediatric severe sepsis remains a burdensome public health problem, with prevalence, morbidity, and mortality rates similar to reports from critically ill adult populations. International clinical trials targeting children with severe sepsis are warranted. PMID: 25734408 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - March 3, 2015 Category: Respiratory Medicine Authors: Weiss SL, Fitzgerald JC, Pappachan J, Wheeler D, Jaramillo-Bustamante JC, Salloo A, Singhi SC, Erickson S, Roy JA, Bush JL, Nadkarni VM, Thomas NJ, for the SPROUT Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Networ Tags: Am J Respir Crit Care Med Source Type: research

Critical illness-related corticosteroid insufficiency (CIRCI): a narrative review from a Multispecialty Task Force of the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM)
ConclusionsNovel insights into the pathophysiology of CIRCI add to the limitations of the current diagnostic tools to identify at-risk patients and may also impact how corticosteroids are used in patients with CIRCI.
Source: Intensive Care Medicine - September 21, 2017 Category: Intensive Care Source Type: research

SCCM Pod-93 ACCM Recommendations for Corticosteroid Insufficiency
Paul Marik, MD, FCCM, discusses the June Critical Care Medicine article, "Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: Consensus statements from an international task force by the American College of Critical Care Medicine." Dr. Marik is the chief of pulmonary and critical care medicine at Thomas Jefferson University in Philadelphia, Pennsylvania, USA. (Crit Care Med 2008;36[6]:1937)
Source: SCCM PodCast - iCritical Care - July 29, 2008 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts

Developing a Clinically Feasible Personalized Medicine Approach to Pediatric Septic Shock.
Conclusions: We developed and tested a gene expression-based classification method for pediatric septic shock that meets the time constraints of the critical care environment, and can potentially inform therapeutic decisions. PMID: 25489881 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - December 9, 2014 Category: Respiratory Medicine Authors: Wong HR, Cvijanovich NZ, Anas N, Allen GL, Thomas NJ, Bigham MT, Weiss SL, Fitzgerald J, Checchia PA, Meyer K, Shanley TP, Quasney M, Hall M, Gedeit R, Freishtat RJ, Nowak J, Shekhar RS, Gertz S, Dawson E, Howard K, Harmon K, Beckman E, Frank E, Lindsell Tags: Am J Respir Crit Care Med Source Type: research

Comparison of Consent Models in a Randomized Trial of Corticosteroids in Pediatric Septic Shock*
Conclusions: Deferred consent was acceptable in time-sensitive critical care research to most research ethics boards, families, and healthcare providers and resulted in higher consent rates and more efficient recruitment. Larger studies on deferred consent and consistency interpreting jurisdictional guidelines are needed to advance pediatric acute care.
Source: Pediatric Critical Care Medicine - November 1, 2017 Category: Pediatrics Tags: Feature Articles Source Type: research

The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase–Associated Lipocalin in Pediatric Heart Surgery*
Conclusions: Preoperatively administered methylprednisolone profoundly decreases plasma neutrophil gelatinase–associated lipocalin levels. Neutrophil gelatinase–associated lipocalin seems to originate to a significant extent from activated neutrophils. Preoperative methylprednisolone is a confounding factor when interpreting plasma neutrophil gelatinase–associated lipocalin levels as a kidney injury marker in pediatric heart surgery.
Source: Pediatric Critical Care Medicine - February 1, 2016 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research