The International Sepsis Forum's controversies in sepsis: corticosteroids should be used to treat septic shock.
The use of corticosteroids in septic shock remains controversial. It has been demonstrated that high doses of steroids (30 mg/kg methylprednisolone) for short periods of time are not beneficial. More recent studies using smaller doses (200-300 mg/day hydrocortisone) for longer periods of time have shown beneficial effects. These positive effects have included reversal of shock, trends toward decreased organ system dysfunction and decreased mortality. Based on the high proportion of patients who have relative adrenal insufficiency, the benefits of low doses of steroids and the minimal risks, steroids should be used to treat septic shock.
Goodman
Sergey
S
Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, The Hebrew University of Jerusalem, Israel.
Sprung
Charles L
CL
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012772:Shock, Septic / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000324:Adrenocorticotropic Hormone