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Corticosteroid Treatment of Patients in Septic Shock

  • C. L. Sprung
  • S. Goodman
  • Y. G. Weiss

Abstract

The use of steroids in septic shock patients has been controversial for decades [1, 2]. High-dose corticosteroids were standard therapy in the 1970s and 1980s [1, 2, 3, 4]. During the late 1980s and 1990s, however, the consensus was that corticosteroids should not be used in sepsis and septic shock after studies did not show an improved survival for patients treated with steroids [5, 6, 7, 8, 9]. Over the last decade, the recognition of inadequate adrenal corticosteroid production became more important as many critically ill patients were found to have relative adrenal insufficiency [10]. Studies in the late 1990s and early 2000s demonstrated hemodynamic benefits with lower doses of steroids for longer periods of time [11, 12, 13, 14, 15, 16]. Unfortunately, steroid use in critically ill patients has been associated with adverse affects [2] especially superinfections [2] and, more recently, critical illness polyneuromyopathy [17, 18]. In view of the ongoing controversy concerning the use of steroids in septic patients and recent studies on the subject, the current chapter attempts to review the topic, weighing the advantages and disadvantages of steroid treatment.

Keywords

Septic Shock Severe Sepsis Septic Shock Patient Survive Sepsis Campaign Shock Reversal 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • C. L. Sprung
    • 1
  • S. Goodman
    • 1
  • Y. G. Weiss
    • 1
  1. 1.General Intensive Care Unit Department of Anesthesiology and Critical CareHadassah Hebrew University Medical CenterJerusalemIsrael

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