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PedsCrit

Corticosteroids in Septic Shock with Dr. Jerry Zimmerman Part 1

Aug 14, 2023
Dr. Jerry Zimmerman, Professor of Pediatrics at the University of Washington and former Chief of the Division of Critical Care Medicine, discusses the use of corticosteroids in septic shock. Topics include the physiologic rationale, clinical evidence, current practice patterns, side effects, and future research. The chapter also highlights the significance of perseverance, teamwork, learning, and addressing burnout in pediatric intensive care.
35:51

Episode guests

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Quick takeaways

  • Children with endotype A, characterized by downregulation of adaptive immune response, have a higher risk of mortality in septic shock, caution should be exercised when administering corticosteroids to these children.
  • The effectiveness of corticosteroids in septic shock is still unclear, with conflicting evidence from adult and pediatric studies, particularly regarding the use of hydrocortisone versus other corticosteroids.

Deep dives

Risk factors associated with poor outcomes in pediatric patients with endotype A

Children with endotype A, characterized by downregulation of adaptive immune response, glucocorticoid receptors, and nitric oxide metabolism, have a higher risk of mortality and longer ICU stay. Administering corticosteroids to these children increases the risk of mortality by fourfold.

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