Pro/con clinical debate: are steroids useful in the management of patients with septic shock?

Crit Care. 2002 Apr;6(2):113-6. doi: 10.1186/cc1467. Epub 2002 Feb 6.

Abstract

Decision-making in the intensive care unit is often very difficult. Although we are encouraged to make evidence-based decisions, this may be difficult for a number of reasons. To begin with, evidence may not exist to answer the clinical question. Second, when there is evidence it may not be applicable to the patient in question or the clinician may be reluctant to apply it to the patient based on a number of secondary issues such as costs, premorbid condition or possible complications. Finally, emotions are often highly charged when caring for patients that have a significant chance of death, and care-givers as well as families are frequently prepared to take chances on a therapy whose benefit is not entirely clear. Steroid use in septic shock is an example of a therapy that makes some sense but has conflicting support in the literature. In this issue of Critical Care Forum, the two sides of this often heated debate are brought to the forefront in an interesting format.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use*
  • Attitude of Health Personnel*
  • Critical Care / methods*
  • Dose-Response Relationship, Drug
  • Humans
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Shock, Septic / drug therapy*

Substances

  • Adrenal Cortex Hormones