Metabolic resuscitation for Pneumonia

Pulm (EMCrit)

Metabolic resuscitation for severe pneumonia?

PulmCrit Wee – July 19, 2018 - By Josh Farkas

"Summary: The Bullet

• The use of steroid for community-acquired pneumonia is supported by several RCTs and currently recommended by SCCM/ESICM guidelines. However, metabolic resuscitation with hydrocortisone, ascorbate, and thiamine remains quite controversial.
• Kim 2018 performed a before/after study evaluating metabolic resuscitation for patients admitted to an ICU with severe pneumonia. Various analyses suggest a mortality benefit, particularly among the sickest patients. However, this study is far from definitive due to numerous limitations.
• A multi-center RCT is needed to address this question. In the interim, outcomes from this hospital suggest that metabolic resuscitation is currently a reasonable treatment option for severe community-acquired pneumonia admitted to the ICU."