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

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• 作者：Baruch M.  ; Batzofin MBBCh  ; ;   ; ^{baruchb@hadassah.org.il} ; Chief Resident ; Charles L.  ; Sprung M.D. ;   ; ^{charless@ekmd.huji.ac.il} ; Director ; General Intensive Care Unit ; Yoram G.  ; Weiss M.D. ;   ; ^{weiss@hadassah.org.il} ; Chairman
• 关键词：corticosteroids ; hydrocortisone ; sepsis ; septic shock ; steroids
• 刊名：Best Practice Research Clinical Endocrinology Metabolism
• 出版年：2011
• 出版时间：October 2011
• 年：2011
• 卷：25
• 期：5
• 页码：735-743
• 全文大小：265 K

文摘

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.