New SCCM Guidelines: Liver Failure, New Fever, and Corticosteroids

Concurrent Session Moderator(s)

• 

  Mark Nunnally, MD, FCCM

  Director, Patient Blood Management
  New York University School of Medicine
  New York, NY
• 

  Mary Reed, MD, FCCM

  Geisinger Medical Center
  Catawissa, PA

New guidelines provide practitioners with evidence-based recommendations to optimize outcomes for critically ill patients with acute and acute-on-chronic liver failure. The guidelines are meant as aids and do not supplant clinical decision-making. They provide up-to-date recommendations for neurologic, infectious disease, gastroenterologic, and peritransplant considerations in patients with acute and acute-on-chronic liver failure. The new fever guidelines update the 2008 Infectious Diseases Society of America and SCCM guidelines for the evaluation of new-onset fever in adult ICU patients without severe immunocompromise. This update uses Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology and includes recommendations for microbiologic studies, imaging procedures, biomarkers, and antipyretics. Dysregulated inflammatory response is common in acutely ill hospitalized patients. Corticosteroids are hypothesized to be beneficial via their broad antiinflammatory mechanisms. New evidence is available for the use of corticosteroids in sepsis, acute respiratory distress syndrome (ARDS) and bacterial community-acquired pneumonia (CAP), warranting a focused update of the 2017 guideline on critical illness-related corticosteroid insufficiency. An SCCM multidisciplinary panel developed evidence-based recommendations for the use of corticosteroids in hospitalized adults and children with sepsis, ARDS, and bacterial CAP. The panel developed five focused population, intervention, control, and outcome (PICO) questions and issued four recommendations using GRADE methodology.

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Congress features sessions on a record-breaking number of new journal articles, guidelines, and research from SCCM and other leading medical journals. Find details here.

Presentations:

• Management of Adult Acute and Acute-on-Chronic Liver Failure
• Evaluation of New Fever in Critically Ill Adult Patients
• 2024 Focused Update Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia