Guidelines for the Management of Pediatric Severe Traumatic Brain Injury

Guidelines for the Management of Pediatric Severe Traumatic Brain Injury

Update of the Brain Trauma Foundation Guidelines, Third Edition. Severe Traumatic Brain Injury in Infants, Children, and Adolescents in 2019: Some Overdue Progress, Many Remaining Questions, and Exciting Ongoing Work in the... read more

Association of Antibiotic Treatment with Outcomes in Patients Hospitalized for an Asthma Exacerbation Treated with Systemic Corticosteroids

Association of Antibiotic Treatment with Outcomes in Patients Hospitalized for an Asthma Exacerbation Treated with Systemic Corticosteroids

Antibiotic therapy may be associated with a longer hospital length of stay, higher hospital cost, and similar risk of treatment failure. These results highlight the need to reduce inappropriate antibiotic prescribing among... read more

Corticosteroid Treatment in Critically Ill Patients with Severe Influenza Pneumonia

Corticosteroid Treatment in Critically Ill Patients with Severe Influenza Pneumonia

Administration of corticosteroids in patients with severe influenza pneumonia is associated with increased ICU mortality, and these agents should not be used as co‑adjuvant therapy. A total of 1846 patients with primary... read more

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

Among adults with COPD at high risk of exacerbation treated with inhaled corticosteroids, the addition of low-dose theophylline, compared with placebo, did not reduce the number COPD exacerbations over a 1-year period. The... read more

Do We Know Enough to Recommend Corticosteroids in ARDS?

Do We Know Enough to Recommend Corticosteroids in ARDS?

We read with interest the evidence-based recommendations for the use of prolonged corticosteroids in early moderate to severe acute respiratory distress syndrome (ARDS) published in Critical Care Medicine by the Corticosteroid... read more

Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far

Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far

Sapru et al. show in this issue of Critical Care that variants of thrombomodulin and the endothelial protein C receptor, but not protein C, are associated with mortality and organ dysfunction (ventilation-free and organ failure-free... read more

Low-dose Corticosteroids for Adult Patients with Septic Shock

Low-dose Corticosteroids for Adult Patients with Septic Shock

The results of this systematic review provide an evidence summary to inform clinicians regarding decisions to use corticosteroids in adult patients with septic shock. We found that assignment to treatment with corticosteroids... read more

An Exploratory Reanalysis of the Randomized Trial on Efficacy of Corticosteroids as Rescue Therapy for the Late Phase of ARDS

An Exploratory Reanalysis of the Randomized Trial on Efficacy of Corticosteroids as Rescue Therapy for the Late Phase of ARDS

During active intervention, methylprednisolone was safe and effective in achieving disease resolution. Our findings support rapid glucocorticoid discontinuation post extubation as likely cause of disease relapse. Gradual... read more

The Case of the Relative Insufficiency

The Case of the Relative Insufficiency

When it comes to the efficacy of glucocorticoid therapy for the treatment of septic shock, we have existed in a state of ambiguity, torn between the results of two contradictory RCTs. The first, the Annane et al trial published... read more

Guidelines for the Diagnosis and Management of Critical Illness-Related Corticosteroid Insufficiency – Part II

Guidelines for the Diagnosis and Management of Critical Illness-Related Corticosteroid Insufficiency – Part II

This part II of the guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients is related to acute illnesses that may be complicated by CIRCI. We... read more

Preadmission Oral Corticosteroids Are Associated With Reduced Risk of ARDS in Critically Ill Adults With Sepsis

Preadmission Oral Corticosteroids Are Associated With Reduced Risk of ARDS in Critically Ill Adults With Sepsis

The unadjusted occurrence rate of acute respiratory distress syndrome within 96 hours of ICU admission was 35% among patients who had received oral corticosteroids compared with 42% among those who had not (p = 0.107). In... read more

Plasma cytokine levels predict response to corticosteroids in septic shock

Plasma cytokine levels predict response to corticosteroids in septic shock

Plasma concentration of selected cytokines is a potential predictive biomarker to identify septic shock patients that may benefit from treatment with corticosteroids.... read more