Pro-con debate: steroid use in ACTH non-responsive septic shock patients with high baseline cortisol levels.
Steroid use in critically ill, vasopressor-dependant, septic patients has gained increased acceptance in recent years with the publication of encouraging data. However, with renewed interest and/or attention comes increased debate and analysis. As a result, it is not surprising to find that there is still significant controversy with regards to the role of steroids in many patients. In this article, two expert groups debate the role of steroid use in a septic shock patient with arguably no clear evidence of adrenal insufficiency.
Annane
Djillali
D
Service de Réanimation, Hôpital Raymond Poincaré (AP-HP), Université de Versailles SQ, Garches, France. djillali.annane@npc.aphp.fr
Fan
Eddy
E
Herridge
Margaret S
MS
D000304:Adrenal Cortex Function Tests / Q000379:methods; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D012772:Shock, Septic / Q000097:blood* / Q000188:drug therapy*; D013256:Steroids / Q000097:blood / Q000627:therapeutic use
D013256:Steroids; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone