Systemic steroids for severe sepsis and septic shock (Review)
www.pulmccm.org
The benefits of corticosteroids as a treatment for severe sepsis and septic shock (if any) are unknown: Although adrenal suppression is common in sepsis, it is still unclear how to assess adrenal function, or whether it should be done at all. The sensitivity and specificity of the cosyntropin (ACTH) stimulation test are unknown, and its utility uncertain. There is no good evidence base even to define what adrenal suppression is (in terms of lab cut-off values) in people with severe sepsis. Nevertheless, the Society of Critical Care Medicine continues to recommend we call it "corticosteroid insufficiency" and define it in the old way (a cortisol increase of <9 mcg/dL after a 250 mcg ACTH stimulation test, or a random cortisol < 10), without advising it be routinely checked.
Systemic steroids for severe sepsis and septic shock (Review)
Systemic steroids for severe sepsis and…
Systemic steroids for severe sepsis and septic shock (Review)
The benefits of corticosteroids as a treatment for severe sepsis and septic shock (if any) are unknown: Although adrenal suppression is common in sepsis, it is still unclear how to assess adrenal function, or whether it should be done at all. The sensitivity and specificity of the cosyntropin (ACTH) stimulation test are unknown, and its utility uncertain. There is no good evidence base even to define what adrenal suppression is (in terms of lab cut-off values) in people with severe sepsis. Nevertheless, the Society of Critical Care Medicine continues to recommend we call it "corticosteroid insufficiency" and define it in the old way (a cortisol increase of <9 mcg/dL after a 250 mcg ACTH stimulation test, or a random cortisol < 10), without advising it be routinely checked.