{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:25:41Z","timestamp":1779272741679,"version":"3.51.4"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n            Kortikoidtherapie bei Sepsis und septischem Schock Bei septischem Schock mit anhaltendem Bedarf an Vasopressoren wird Hydrocortison in einer Gesamtdosis von 200mg\/Tag empfohlen. Bei Sepsis ohne Schock ergibt sich kein Vorteil. Neuere Studien zeigen Vorteile bei einer Kombination von Hydrocortison mit Fludrocortison; klare Leitlinien-Empfehlungen dazu stehen aber noch aus.<\/jats:p><jats:p>\n            Kortikoidtherapie bei schwerer ambulant erworbener Pneumonie Nach den Ergebnissen einer gro\u00dfen, randomisierten und multizentrischen Studie zur Gabe von Hydrocortison (200mg\/Tag) bei schwerer ambulant erworbener Pneumonie reduziert die Gabe die Sterblichkeit signifikant. Aus diesen Gr\u00fcnden wird eine fr\u00fchzeitige Kortikosteroid-Therapie analog zum Studienprotokoll mittlerweile empfohlen. Bei influenzaassoziierter ambulant erworbener Pneumonie sollte keine Therapie mit Kortikosteroiden durchgef\u00fchrt werden, da Studien eine h\u00f6here Komplikationsrate zeigten. Demgegen\u00fcber konnte bei COVID-19 durch den Einsatz von Dexamethason (6mg) eine signifikant geringere 28-Tage-Sterblichkeit beobachtet werden.<\/jats:p><jats:p>\n            Kortikoidtherapie bei akutem Lungenversagen Nach Dekaden kontroverser Diskussionen empfehlen aktuelle Leitlinien mittlerweile auch beim ARDS den Einsatz von Kortikosteroiden nach strenger Nutzen-Risiko-Analyse. Diese Empfehlungen basieren \u00fcberwiegend auf Studien, die fr\u00fchzeitig mit der Steroidtherapie begonnen haben. Viele Fragen, wie nach der Art des Kortikosteroids, dem Zeitpunkt und der Dauer der Therapie, sowie die Dosierung bleiben allerdings nach wie vor offen.<\/jats:p>","DOI":"10.1055\/a-2128-5319","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T22:43:13Z","timestamp":1716504193000},"page":"714-718","source":"Crossref","is-referenced-by-count":1,"title":["Kortikosteroide in der Intensivmedizin"],"prefix":"10.1055","volume":"149","author":[{"given":"Barbara","family":"Sensen","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Intensivmedizin, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Nierhaus","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Intensivmedizin, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Kluge","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Intensivmedizin, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1007\/s00134-017-4914-x","article-title":"Critical illness-related corticosteroid insufficiency (CIRCI): a narrative review from a Multispecialty Task Force of the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM)","volume":"43","author":"D Annane","year":"2017","journal-title":"Intensive Care Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1007\/s00063-023-01093-w","article-title":"Corticosteroids in sepsis and community-acquired pneumonia","volume":"118","author":"A Guzzardella","year":"2023","journal-title":"Med Klin Intensivmed Notfmed"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000006172","article-title":"2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia","author":"D Chaudhuri","year":"2024","journal-title":"Crit Care Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e1063","DOI":"10.1097\/ccm.0000000000005337","article-title":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021","volume":"49","author":"L Evans","year":"2021","journal-title":"Crit Care Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s00063-020-00685-0","article-title":"S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version","volume":"115","author":"FM Brunkhorst","year":"2020","journal-title":"Med Klin Intensivmed Notfmed"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1001\/jamainternmed.2023.0258","article-title":"Comparative Effectiveness of Fludrocortisone and Hydrocortisone vs Hydrocortisone Alone Among Patients With Septic Shock","volume":"183","author":"NA Bosch","year":"2023","journal-title":"JAMA Intern Med"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202310-1785OC","article-title":"Effectiveness of Fludrocortisone Plus Hydrocortisone Versus Hydrocortisone Alone in Septic Shock: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials","author":"B Teja","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"issue":"06","key":"ref8","doi-asserted-by":"publisher","first-page":"EVIDoa2300034","DOI":"10.1056\/EVIDoa2300034","article-title":"Patient-Level Meta-Analysis of Low-Dose Hydrocortisone in Adults with Septic Shock","volume":"2","author":"R Pirracchio","year":"2023","journal-title":"NEJM Evid"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1055\/a-1497-0693","article-title":"Deutsche Gesellschaft f\u00fcr Pneumologie und Beatmungsmedizin. 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