26 Nov 2025
54m

Lightning rounds 58: Steroids for septic shock with David Janz

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Critical Care Scenarios

The podcast episode centers on the use of steroids in the ICU, particularly for patients with septic shock. It addresses the debate around whether to stimulate or suppress the immune system in infected patients, noting the historical shift towards using steroids to decrease inflammation. The discussion highlights that while steroids can raise blood pressure and help patients get off vasopressors quicker, potential harms include hyperglycemia and increased risk of infections. The guest, Dr. David Janz, explains that the decision to use steroids often depends on the severity of the patient's condition, balancing potential benefits against risks, and shares his approach to steroid administration based on vasopressor requirements and organ failure progression.

Outlines

Part 1: Introduction, Mechanisms

Part 2: Research, Guidelines, Clinical Decision-Making

Part 3: Administration, Dosing, Discontinuation

Part 4: Special Cases, Other Shocks

Part 5: Conclusion, Summary

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