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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
1   Programa de Pós-Graduação em Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
2   Intensive Care Unit, Grupo Hospitalar Conceição, Porto Alegre, Brazil
,
Thiago Lisboa
3   Critical 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
4   Programa de Pós-Graduação em Saúde e Desenvolvimento Humano, Universidade Unilasalle, Canoas, Brazil
5   Instituto de Pesquisa, HCOR, São Paulo, Brazil
,
Jorge I.F. Salluh
6   Department of Critical Care and Postgraduate Program in Translational Medicine, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
7   Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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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


Publication History

Article published online:
20 September 2021

© 2021. Thieme. All rights reserved.

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