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JAMA Clinical Reviews

Low-Dose Corticosteroids for Critically Ill Adults With Severe Pulmonary Infections

Jun 12, 2024
Expert in critical care medicine, Romain Pirracchio, discusses the benefits of using low-dose corticosteroids in treating severe pulmonary infections. Topics include the use of corticosteroids in COVID-19 cases, positive impacts on mortality in Community-Acquired Pneumonia, and guidelines for timely initiation of treatment in critically ill patients.
17:20

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Quick takeaways

  • Shift from high- to low-dose corticosteroids due to inflammation balance.
  • Meta-analysis shows low-dose corticosteroids reduce mortality and respiratory support need in severe CAP.

Deep dives

Use of Low-Dose Corticosteroids for Severe Pulmonary Infections

Dr. Perrecchio discusses the importance of managing severe pulmonary infections, which are a leading cause of adult mortality. The shift from high-dose to low-dose corticosteroids due to new understandings of inflammation balance is highlighted. The definition of low-dose corticosteroids, including doses below 400 milligrams per day of hydrocortisone equivalents, is explained. Specific examples from COVID-19 treatment protocols with 6 milligrams of dexamethasone daily are mentioned.

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