A Randomized Controlled Trial of Corticosteroids in Pediatric Septic Shock: A Pilot Feasibility Study

Pediatric Critical Care Medicine

Volumn 18, Issue 6, 2017, Pages 505-512

  Menon, Kusum ^a   McNally, Dayre ^a   O'Hearn, Katharine ^a   Acharya, Anand ^b   Wong, Hector R ^c   Lawson, Margaret ^a   Ramsay, Tim ^d   McIntyre, Lauralyn ^e   Gilfoyle, Elaine ^f   Tucci, Marisa ^g   Wensley, David ^h   Gottesman, Ronald ⁱ   Morrison, Gavin ^j   Choong, Karen ^k  

^a CHILDREN S HOSPITAL OF EASTERN ONTARIO   (Canada)

^b CARLETON UNIVERSITY   (Canada)

^c UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE   (United States)

^d OTTAWA HOSPITAL RESEARCH INSTITUTE   (Canada)

^e UNIVERSITY OF OTTAWA   (Canada)

^f ALBERTA CHILDREN'S HOSPITAL   (Canada)

^g UNIVERSITY OF MONTREAL   (Canada)

^h UNIVERSITY OF BRITISH COLUMBIA   (Canada)

ⁱ MONTREAL CHILDREN S HOSPITAL   (Canada)

^j IWK HEALTH CENTRE   (Canada)

^k MCMASTER UNIVERSITY   (Canada)

more..

Author keywords

Corticosteroids; pediatric septic shock; randomized controlled trial; sepsis; steroids

Indexed keywords

HYDROCORTISONE; HYPERTENSIVE FACTOR; ANTIINFLAMMATORY AGENT;

ADOLESCENT; ARTICLE; ARTIFICIAL VENTILATION; CHILD; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; FEASIBILITY STUDY; FEMALE; GASTROINTESTINAL HEMORRHAGE; HEMODYNAMICS; HOSPITAL ADMISSION; HUMAN; INFANT; INFECTION; INSULIN INFUSION; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; NEWBORN; PEDIATRIC INTENSIVE CARE UNIT; PILOT STUDY; PRIORITY JOURNAL; RANDOMIZATION; RANDOMIZED CONTROLLED TRIAL; SCREENING TEST; SEPTIC SHOCK; TIME TO TREATMENT; CLINICAL TRIAL; DRUG ADMINISTRATION; INTRAVENOUS DRUG ADMINISTRATION; MULTICENTER STUDY; PRESCHOOL CHILD; TREATMENT OUTCOME;

ADOLESCENT; ANTI-INFLAMMATORY AGENTS; CHILD; CHILD, PRESCHOOL; DOUBLE-BLIND METHOD; DRUG ADMINISTRATION SCHEDULE; FEASIBILITY STUDIES; FEMALE; HUMANS; HYDROCORTISONE; INFANT; INFANT, NEWBORN; INJECTIONS, INTRAVENOUS; INTENSIVE CARE UNITS, PEDIATRIC; MALE; PILOT PROJECTS; SHOCK, SEPTIC; TREATMENT OUTCOME;

EID: 85017424083     PISSN: 15297535     EISSN: 19473893     Source Type: Journal    
DOI: 10.1097/PCC.0000000000001121     Document Type: Article

References (28)

1. Menon K, McNally JD, Choong K, et al.; Canadian Critical Care Trials Group STRIPES Investigators: A cohort study of pediatric shock: Frequency of corticosteriod use and association with clinical outcomes. Shock 2015; 44:402-409
2. Kissoon N, Carcillo JA, Espinosa V, et al.; Global Sepsis Initiative Vanguard Center Contributors: World Federation of Pediatric Intensive Care and Critical Care Societies: Global Sepsis Initiative. Pediatr Crit Care Med 2011; 12:494-503
3. Schlapbach LJ, Straney L, Alexander J, et al.; ANZICS Paediatric Study Group: Mortality related to invasive infections, sepsis, septic shock in critically ill children in Australia and New Zealand, 2002-13: A multicentre retrospective cohort study. Lancet Infect Dis 2015; 15:46-54
4. Valoor HT, Singhi S, Jayashree M: Low-dose hydrocortisone in pediatric septic shock: An exploratory study in a third world setting. Pediatr Crit Care Med 2009; 10:121-125
5. Slusher T, Gbadero D, Howard C, et al.: Randomized, placebo-controlled, double blinded trial of dexamethasone in African children with sepsis. Pediatr Infect Dis J 1996; 15:579-583
6. Weiss SL, Fitzgerald JC, Pappachan J, et al.; Sepsis Prevalence, Outcomes, Therapies (SPROUT) Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network: Global epidemiology of pediatric severe sepsis: The sepsis prevalence, outcomes, therapies study. Am J Respir Crit Care Med 2015; 191:1147-1157
7. Dellinger RP, Levy MM, Rhodes A, et al.; Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013; 39:165-228
8. Menon K, McNally D, Choong K, et al.: A systematic review and metaanalysis on the effect of steroids in pediatric shock. Pediatr Crit Care Med 2013; 14:474-480
9. Annane D, Bellissant E, Bollaert PE, et al.: Corticosteroids in the treatment of severe sepsis and septic shock in adults: A systematic review. JAMA 2009; 301:2362-2375
10. Sasidharan P: Role of corticosteroids in neonatal blood pressure homeostasis. Clin Perinatol 1998; 25:723-740, xi
11. Markovitz BP, Goodman DM, Watson RS, et al.: A retrospective cohort study of prognostic factors associated with outcome in pediatric severe sepsis: What is the role of steroids Pediatr Crit Care Med 2005; 6:270-274
12. Wong HR, Cvijanovich NZ, Allen GL, et al.: Corticosteroids are associated with repression of adaptive immunity gene programs in pediatric septic shock. Am J Respir Crit Care Med 2014; 189:940-946
13. Menon K, Lawson M: Identification of adrenal insufficiency in pediatric critical illness. Pediatr Crit Care Med 2007; 8:276-278
14. Menon K, McNally JD, Choong K, et al.: A survey of stated physician practices and beliefs on the use of steroids in pediatric fluid and/or vasoactive infusion-dependent shock. Pediatr Crit Care Med 2013; 14:462-466
15. Carmean A, Fortenberry JD, McCracken C, et al.: A survey of attitudes and practices regarding the use of steroid supplementation in pediatric sepsis. Pediatr Emerg Care 2015; 31:694-698
16. Sprung CL, Annane D, Keh D, et al.; CORTICUS Study Group: Hydrocortisone therapy for patients with septic shock. N Engl J Med 2008; 358:111-124
17. Annane D, Sébille V, Charpentier C, et al.: Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288:862-871
18. Duffett M, Choong K, Hartling L, et al.: Randomized controlled trials in pediatric critical care: A scoping review. Crit Care 2013; 17:R256
19. Menon K, Wong HR: Corticosteroids in pediatric shock: A call to arms. Pediatr Crit Care Med 2015; 16:e313-e317
20. Menon K, Ward RE, Gaboury I, et al.: Factors affecting consent in pediatric critical care research. Intensive Care Med 2012; 38:153-159
21. Duffett M, Choong K, Hartling L, et al.: Pilot randomized trials in pediatric critical care: A systematic review. Pediatr Crit Care Med 2015; 16:e239-e244
22. O'Hearn K, McNally D, Choong K, et al.; Canadian Critical Care Trials Group: Steroids in fluid and/or vasoactive infusion dependent pediatric shock: Study protocol for a randomized controlled trial. Trials 2016; 17:238
23. Keh D, Boehnke T, Weber-Cartens S, et al.: Immunologic and hemodynamic effects of "low-dose" hydrocortisone in septic shock: A doubleblind, randomized, placebo-controlled, crossover study. Am J Respir Crit Care Med 2003; 167:512-520
24. Goldstein B, Giroir B, Randolph A: International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005; 6:2-8
25. Averill RF, Mullin RL, Steinbeck BA, et al.: Development of the ICD-10 procedure coding system (ICD-10-PCS). Top Health Inf Manage 2001; 21:54-88
26. Weiss SL, Parker B, Bullock ME, et al.: Defining pediatric sepsis by different criteria: Discrepancies in populations and implications for clinical practice. Pediatr Crit Care Med 2012; 13:e219-e226
27. Weiss SL, Fitzgerald JC, Maffei FA, et al.; SPROUT Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators Network: Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study. Crit Care 2015; 19:325
28. Menon K: Use of hydrocortisone for refractory shock in children. Crit Care Med 2013; 41:e294-e295