Updating evidence role corticosteroids severe sepsis septic shock

This cookie stores just a session ID; no other information is captured.Accepting the NEJM cookie is necessary to use the website.Multiple corticosteroids and treatment regimens have been used as adjuncts in the treatment of septic shock.

The thickness of the nodes and edges in each network is proportional to the number of patients allocated to each intervention and contributing to each pairwise comparison, respectively.The place of therapeutic corticosteroids in critically ill patients with sepsis is controversial. First, is there a group of critically ill patients who are relatively deficient in corticosteroids, and if so, how they should they be treated [1]?Second, do steroids given to all critically ill patients improve outcomes [2]?Even at dose equivalency, some corticosteroids have more immunosuppressive properties (e.g., dexamethasone), and some have more mineralocorticoid and vasoreactive properties (e.g., hydrocortisone) [5].This, tied with the evidence that endogenous glucocorticoids are secreted in a pulsatile manner in health [6], major surgery [7] and critical illness [8] warranted further analysis of the effects of the individual drugs and the dose regimens used.

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