More Support for Using Steroids in Patients with Refractory Septic Shock

In an observational study, steroid therapy was associated with lower mortality in the sickest patients.

The most recent Surviving Sepsis Guidelines (Crit Care Med 2013; 41:580) suggest that steroids (200 mg hydrocortisone daily) should be used only when volume resuscitation and vasopressors cannot restore hemodynamic stability. Investigators examined data on patients who were treated for septic shock at 28 hospitals in Canada, the U.S., and Saudi Arabia; 1838 patients who received low-dose steroids (<80 mg prednisone equivalent daily) were compared with a propensity-matched cohort that did not. Patients were excluded if they died within 48 hours of intensive care unit (ICU) admission or received steroids later than 48 hours after documentation of shock.

ICU, hospital, and 30-day mortality did not differ between groups. In subgroup analyses, 30…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

More Support for Using Steroids in Patients with Refractory Septic Shock

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Reviewing Author