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During the past 2 decades, many researchers have examined potential therapies for sepsis. Two new trials join the growing body of literature that demonstrates the complexity of the syndrome and the challenges of modifying the physiologic response and providing hemodynamic support.
Investigators from Germany randomized 380 patients with severe sepsis (defined by presence of two or more systemic inflammatory response syndrome [SIRS] criteria, evidence of infection, and organ dysfunction) to receive hydrocortisone (50-mg bolus, 200 mg daily as a continuous infusion for the first 5 days, and tapered over 11 days) or placebo with the goal of preventing progression to septic shock. Incidences of septic shock and mortality and hospital and intensiv…