Corticosteroids in Septic Shock with Dr. Jerry Zimmerman Part 2

Aug 21, 2023

Dr. Jerry Zimmerman, Professor of Pediatrics, discusses the physiologic rationale and clinical evidence for using corticosteroids in septic shock. They explore the potential benefits and adverse effects of corticosteroids in conditions like COVID-19 and ARDS. They also discuss the use of oxandrolone for muscle protein accretion and the future of clinical research. Additionally, they cover the use of corticosteroids in adrenal insufficiency, ACTH stimulation tests, and optimal cortisol cutoffs.

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Introduction

00:00 • 4min

The Use of Corticosteroids in Septic Shock

04:19 • 5min

Oxandrolone, Research Infrastructure, and the Future of Clinical Research

09:37 • 3min

Use of Corticosteroids in Septic Shock and ACTH Stimulation Tests

12:47 • 12min

Wrapping up the Conversation and Contact Information

24:37 • 2min

Jerry Zimmerman, M.D, PhD, FCCM is a Professor of Pediatrics at the University of Washington and the former Chief of the Division of Critical Care Medicine and the Director of the Pediatric Intensive Care Unit at Seattle Children’s Hospital. He is a past president of the Society of Critical Care Medicine. Dr. Zimmerman is the co-editor of the textbook Pediatric Critical Care and is an accomplished researcher. He was a charter principal investigator in the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) network and is a co-principal investigator for the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) trial that we will discuss later in this episode.

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The physiologic rationale supporting and opposing the use of corticosteroids in septic shock.
The high-quality clinical evidence supporting and opposing the use of corticosteroids in septic shock.
The current practice patterns among pediatric intensivists in prescribing corticosteroids in septic shock.
The clinically relevant side effects associated with corticosteroids in septic shock.
Future research of corticosteroids in septic shock with emphasis on the Stress Hydrocortisone in Pediatric Septic Shock (SHIPSS) study.

Key reference:

Zimmerman, Jerry J. MD, PhD, FCCM. A history of adjunctive glucocorticoid treatment for pediatric sepsis: Moving beyond steroid pulp fiction toward evidence-based medicine. Pediatric Critical Care Medicine: November 2007 - Volume 8 - Issue 6 - p 530-539

Other references:

PMID: 32058370
PMID: 20228689
PMID: 29979221
PMID: 29490185
PMID: 29347874
PMID: 27695824
PMID: 18184957
PMID: 12186604

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Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.