My historical perspective on pneumonia: In 1979-80, when I was an intern in NYC, otherwise young, healthy individuals who presented with pneumonia were diagnosed with either pneumococcal pneumonia or mycoplasma pneumonia. Then we began seeing otherwise previously healthy young men present with Pneumocystis carinii Pneumonia which was how AIDS presented before it had been defined.
Interesting choice of steroids. I would have tried prednisone. Also glad to add “radiologist” to my tagline after reading this post, ha! 😜
I’ve been trying ChatGPT with caution for questions at the point of care. Sorry for the long comment but here’s what I got as inspired by this post. After reading this your commenters will also be ICU intensivists, kind of:
Q :
Do steroids help with treating pneumonia for patients in the ICU? Please cite medical references from the New England journal of medicine, Chest journal, and JAMA
A:
There is ongoing debate regarding the use of steroids in the treatment of pneumonia in critically ill patients, including those in the ICU. However, several studies have explored the potential benefits of steroids in this setting.
One study published in the New England Journal of Medicine in 2018, the Steroids in Pneumonia (STRAIN) trial, found that the use of corticosteroids in patients with community-acquired pneumonia who required ICU admission resulted in a significantly lower 90-day mortality rate compared to those who received placebo. The study also found that the steroid group had a shorter time to clinical stability and a lower incidence of treatment failure. (https://www.nejm.org/doi/full/10.1056/NEJMoa1800897)
Another study published in Chest in 2021, which analyzed data from multiple randomized controlled trials, found that corticosteroids reduced mortality and the need for mechanical ventilation in critically ill patients with pneumonia. However, the study also noted that the optimal timing, dose, and duration of corticosteroid treatment in these patients remains unclear. (https://www.sciencedirect.com/science/article/pii/S0012369221001977)
Similarly, a systematic review and meta-analysis published in JAMA in 2020 found that corticosteroid treatment was associated with a lower mortality rate and reduced need for mechanical ventilation in patients with severe pneumonia, including those in the ICU. However, the study also noted that the optimal timing, dose, and duration of corticosteroid treatment in these patients remains uncertain. (https://jamanetwork.com/journals/jama/fullarticle/2766145)
It is important to note that while these studies suggest potential benefits of steroid use in critically ill patients with pneumonia, the decision to use steroids should be made on a case-by-case basis by the treating physician, taking into account factors such as the patient's overall health, the severity of their illness, and potential risks and benefits of steroid therapy.
My historical perspective on pneumonia: In 1979-80, when I was an intern in NYC, otherwise young, healthy individuals who presented with pneumonia were diagnosed with either pneumococcal pneumonia or mycoplasma pneumonia. Then we began seeing otherwise previously healthy young men present with Pneumocystis carinii Pneumonia which was how AIDS presented before it had been defined.
Interesting choice of steroids. I would have tried prednisone. Also glad to add “radiologist” to my tagline after reading this post, ha! 😜
I’ve been trying ChatGPT with caution for questions at the point of care. Sorry for the long comment but here’s what I got as inspired by this post. After reading this your commenters will also be ICU intensivists, kind of:
Q :
Do steroids help with treating pneumonia for patients in the ICU? Please cite medical references from the New England journal of medicine, Chest journal, and JAMA
A:
There is ongoing debate regarding the use of steroids in the treatment of pneumonia in critically ill patients, including those in the ICU. However, several studies have explored the potential benefits of steroids in this setting.
One study published in the New England Journal of Medicine in 2018, the Steroids in Pneumonia (STRAIN) trial, found that the use of corticosteroids in patients with community-acquired pneumonia who required ICU admission resulted in a significantly lower 90-day mortality rate compared to those who received placebo. The study also found that the steroid group had a shorter time to clinical stability and a lower incidence of treatment failure. (https://www.nejm.org/doi/full/10.1056/NEJMoa1800897)
Another study published in Chest in 2021, which analyzed data from multiple randomized controlled trials, found that corticosteroids reduced mortality and the need for mechanical ventilation in critically ill patients with pneumonia. However, the study also noted that the optimal timing, dose, and duration of corticosteroid treatment in these patients remains unclear. (https://www.sciencedirect.com/science/article/pii/S0012369221001977)
Similarly, a systematic review and meta-analysis published in JAMA in 2020 found that corticosteroid treatment was associated with a lower mortality rate and reduced need for mechanical ventilation in patients with severe pneumonia, including those in the ICU. However, the study also noted that the optimal timing, dose, and duration of corticosteroid treatment in these patients remains uncertain. (https://jamanetwork.com/journals/jama/fullarticle/2766145)
It is important to note that while these studies suggest potential benefits of steroid use in critically ill patients with pneumonia, the decision to use steroids should be made on a case-by-case basis by the treating physician, taking into account factors such as the patient's overall health, the severity of their illness, and potential risks and benefits of steroid therapy.
~
Not bad, right?
Wow! Incredible!!