Critical Care, Pulmonary, COVID-19, Deep Dive in CritCare

Corticosteroid Use in COVID-19 Respiratory Failure: Deep Dive into the Evidence

This EMRA Deep Dive will examine the trials that currently guide corticosteroid use in COVID-19 related respiratory failure.

BACKGROUND
The role of corticosteroids in severe infections, sepsis and ARDS has been a constantly evolving discussion and remains controversial. The recent APROCCHSs, ADRENAL and DEXA-ARDS along with other prior data have shown the benefits of corticosteroids for sepsis and ARDS, however their use is not universal.1,2,3 The COVID-19 pandemic has further highlighted the need for strong RCTs to guide appropriate management.

CONCLUSION
Corticosteroids have demonstrated safety in the critically ill and have proven benefits for patients in sepsis and septic shock. This appears to remain true for COVID-19 infections requiring oxygen. Following the results of these aggregate studies, the WHO recommends systemic corticosteroids for patients with COVID-19 infection requiring oxygen.

Access the PowerPoint deck or read on to view the slides.


COVID Steroids Slide2.png

Read the full Critical Care Alert.


COVID Steroids Slide3.png

Read the full Critical Care Alert.


COVID Steroids Slide4.png

Read the full Critical Care Alert.


COVID Steroids Slide5.png

Read the full Critical Care Alert.


COVID Steroids Slide6.png

Read the full Critical Care Alert.


REFERENCES

  1. Annane D, Renault A, Brun-Buisson C, et al. Hydrocortisone plus Fludrocortisone for Adults with Septic Shock. N Engl J Med. 2018;378(9):809-18.
  2. Venkatesh B, Finfer S, Cohen J, et al. Adjunctive glucocorticoid therapy in patients with septic shock. N Engl J Med. 2018;378(9):797-808.
  3. Villar J, Ferrando C, Martínez D, et al. Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial. Lancet Resp Med. 2020;8(3):267-76.

Related Articles

Case Report: Managing a Left-sided Tension Pneumothorax with Patient History of Remote Right Pneumonectomy

The leading cause of iatrogenic pneumothorax is transthoracic needle aspiration. In our case, however, pneumothorax was most likely due to transbronchial lung biopsy two days prior to presentation. Al

Critical Care ECMO Series: Introduction to ECMO

Extracorporeal membrane oxygenation (ECMO) allows for temporary life support in cardiopulmonary failure refractory to conventional medical treatment. Given its capabilities and increasing presence in
CHAT NOW
CHAT OFFLINE