How is corticosteroid therapy used in the treatment of sepsis/septic shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Corticosteroid insufficiency has been associated with severe illness. [96] The American College of Critical Care Medicine (ACCCM) uses the term “critical illness-related corticosteroid insufficiency” (CIRCI) to describe hypothalamic-pituitary-adrenal (HPA) axis dysfunction in critically ill patients and recommends avoiding use of the terms “absolute” or “relative” adrenal insufficiency in such patients. [65]

Although there is theoretical and experimental animal evidence favoring the use of large doses of corticosteroids (eg, methylprednisolone, hydrocortisone, and dexamethasone) in patients with sepsis and septic shock, the clinical medical literature does not support the routine use of such doses in these patients.


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