Ok team. Rubber meets the road
Its a bad flu year so we have to talk about it.
We have CAPE COD trial, and updated guidelines for steroids in CAP, and a shift toward erring on the side of using steroids for CAP and ARDS
Traditionally based on observational data alone steroids not rec’d in FLU+ CAP
Its a bad flu year so we have to talk about it.
We have CAPE COD trial, and updated guidelines for steroids in CAP, and a shift toward erring on the side of using steroids for CAP and ARDS
Traditionally based on observational data alone steroids not rec’d in FLU+ CAP
Comments
CAPECOD excluded FLU+ pts.
Yet many severe CAP and ARDS are caused by FLU and a non trivial number of them are c/b bacterial PNA.
Are we using steroids for severe CAP or ARDS in FLU+ patients?
Disclosure: I have been 🤫 🤐
But Flu = CAP. Many (most?) CAP is viral, flu is a common pathogen.
So youre saying lobar consolidations, elevated procal etc youre using steroids, but diffuse GGOs, lower procal, but still sick, no.
Thats reasonable honestly, just seems like a lot of overlap.
Also timeline? Bacterial superinfection is usually second… so if initial sx started a while ago and the second hit is what brought them here, more likely to think the bacterial PNA is the bigger problem
“Our data strongly suggest that corticosteroids should not be used as co-adjuvant therapy in patients with influenza pneumonia”
https://link.springer.com/article/10.1007/s00134-018-5332-4