The use of steroids in the treatment of severe sepsis and septic shock

Sepsis and septic shock remain major causes of mortality and morbidity worldwide. Previously, high dose corticosteroids were used to dampen the inflammatory response but studies and meta-analyses showed this to be of no benefit and possibly detrimental. Subsequently, low dose corticosteroids were us...

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Bibliographic Details
Published in:Baillière's best practice & research. Clinical endocrinology & metabolism 2011-10, Vol.25 (5), p.735-743
Main Authors: Batzofin, Baruch M., MBBCh, Sprung, Charles L., M.D, Weiss, Yoram G., M.D
Format: Article
Language:English
Subjects:
corticosteroids
Endocrinology & Metabolism
hydrocortisone
sepsis
septic shock
steroids
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Summary:Sepsis and septic shock remain major causes of mortality and morbidity worldwide. Previously, high dose corticosteroids were used to dampen the inflammatory response but studies and meta-analyses showed this to be of no benefit and possibly detrimental. Subsequently, low dose corticosteroids were used in the treatment of sepsis and septic shock with the hypothesis that these conditions are associated with relative adrenal insufficiency. Although some studies showed promising results larger studies and meta-analyses have failed to reproduce these effects and the use of corticosteroids in the treatment of sepsis and septic shock remains controversial. We review the current literature and guidelines regarding low dose corticosteroid use in the management of sepsis and septic shock.
ISSN:1521-690X
1878-1594
DOI:10.1016/j.beem.2011.05.006