Pharmacy to Dose: The Critical Care Podcast ARDS Clinical Pearls
Jul 3, 2025
Dixie Pyles, a PGY2 critical care pharmacy resident specializing in neurology, and Nick Kim, an emergency pharmacist and PGY2 resident, dive into the complexities of managing ARDS. They discuss the critical role of corticosteroids, exploring dosing strategies and the importance of timing in administration. Nick sheds light on the use of inhaled prostacyclins, highlighting their potential benefits in treatment. Together, they emphasize evidence-based practices and the evolving definitions of ARDS to enhance patient outcomes.
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No One-Size Steroid in ARDS
- There is no single preferred steroid for ARDS; selection depends on patient factors and ARDS cause.
- Steroids should be initiated early and dosed as per evidence with careful monitoring to maximize benefit and minimize harm.
Manage Steroid-Induced Hyperglycemia
- Monitor blood glucose closely when steroids are used in ARDS and start insulin therapy as needed even in patients without diabetes.
- Adjust insulin appropriately during and after steroid treatment to avoid hypo- or hyperglycemia.
Understanding ARDS Pathophysiology
- ARDS progresses through exudative, proliferative, and fibrotic stages, involving inflammation, lung injury, and potential fibrosis.
- Understanding the stages helps tailor treatments and recognize the timing when interventions like steroids are most beneficial.