Steroid Dosing by bioMARker Guided Titration in Critically Ill Patients With Pneumonia
| Status: | Not yet recruiting |
|---|---|
| Conditions: | Pneumonia, Hospital |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/27/2019 |
| Start Date: | July 2019 |
| End Date: | July 2022 |
SMART Trial: Steroid Dosing by bioMARker Guided Titration in Critically Ill Patients With Pneumonia
Patients with severe community acquired pneumonia may benefit from adjunctive corticosteroid
therapy. The optimal patient selection, dosing and duration of steroids is unknown. This
study compares a standard steroid dosing algorithm to a novel biomarker-tailored steroid
dosing algorithm for patients receiving corticosteroids for community acquired pneumonia.
therapy. The optimal patient selection, dosing and duration of steroids is unknown. This
study compares a standard steroid dosing algorithm to a novel biomarker-tailored steroid
dosing algorithm for patients receiving corticosteroids for community acquired pneumonia.
Inclusion criteria:
- Emergency room patients with community acquired pneumonia and acute respiratory
failure (SaO2/FiO2 < 315 or PaO2/FiO2 < 300) whose bedside providers intend to use
adjunctive corticosteroid treatment within 12 hours of ED presentation.
Exclusion Criteria:
- Pre-admission chronic use of steroids or other immunosuppressive medications
- Adrenal insufficiency
- Comfort care
- Leukopenia <1000/mm or neutropenia <500/mm (except if attributable to pneumonia) and
HIV positive with a CD4 count <100
- Recent or past history of bone marrow or solid organ transplantation
- Hospital admission in the previous 90 days
- Suspected flare of Interstitial lung disease (infectious and non-infectious)
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