What Is the Role of Steroids for Septic Shock in 2021?

Wagner Nedel; Thiago Lisboa; Jorge I.F. Salluh

doi:10.1055/s-0041-1733900

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2021; 42(05): 726-734
DOI: 10.1055/s-0041-1733900

Review Article

What Is the Role of Steroids for Septic Shock in 2021?

Wagner Nedel

¹Programa de Pós-Graduação em Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

²Intensive Care Unit, Grupo Hospitalar Conceição, Porto Alegre, Brazil

,

Thiago Lisboa

³Critical Care Department, Programa de Pós-Graduação em Ciencias Pneumologicas, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

⁴Programa de Pós-Graduação em Saúde e Desenvolvimento Humano, Universidade Unilasalle, Canoas, Brazil

⁵Instituto de Pesquisa, HCOR, São Paulo, Brazil

,

Jorge I.F. Salluh

⁶Department of Critical Care and Postgraduate Program in Translational Medicine, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil

⁷Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

› Author Affiliations

Abstract

Corticosteroids have been used for decades in the adjunctive treatment of severe infections in intensive care. The most frequent scenario in intensive care is in septic shock, where low doses of glucocorticoids appear to restore vascular responsiveness to norepinephrine. There is a strong body of evidence suggesting that hydrocortisone reduces time on vasopressor, and may modulate the immune response. In this review, we explore the current evidence supporting the use of corticosteroids in septic shock, its benefits, and potential harms. In addition to landmark clinical trials, we will also describe new frontiers for the use of corticosteroids in septic shock which should be explored in future studies.

Keywords

septic shock - corticosteroids - clinical trials

Full Text

References

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