Role of steroids in critically-ill sepsis patients: a review article and literature to review

Figures & data

Table

S.No	Author	Topic	Outcome
1	Annane et al. [8]	Effect of low doses of corticosteroids in septic shock patients with or without early acute respiratory distress syndrome	Non-responders with ARDS treated with dexamethasone were associated with better outcomes. No significant difference between adverse effects
2	Arabi et al. [9]	Low dose hydrocortisone in patients with cirrhosis and septic shock: a randomized controlled trial	Treatment group had significantly reduced required doses of vasopressor, increased rate of shock reversal, no reduction in 28-day mortality, increased adverse effects mostly gastrointestinal bleeding & hyperglycemia
3	Casserly et al. [10]	Low-dose steroids in adult septic shock: results of the Surviving Sepsis Campaign	Significantly increase mortality in treatment group
4	Nazer et al. [11]	Evaluating the effectiveness and safety of hydrocortisone therapy in cancer patients with septic shock	Reversal of septic shock in 47.9%, higher incidence of secondary infections (44.8% vs 27.4%) in the treatment group.
5	Tongyoo et al. [12]	Hydrocortisone treatment in early sepsis- associated acute respiratory distress syndrome: results of a randomized controlled trial	Hydrocortisone group exhibited significant improvement in pulmonary function and lung injury score, shorter duration of vasopressor therapy, but increased incidence of hyperglycemia.
6	Gibbison et al. [13]	Corticosteroids in septic shock: a systematic review and meta-analysis	Hydrocortisone showed better results for shock reversal in comparison with methylprednisolone or placebo. Higher rate of secondary infections in the treatment groups
7	Annane et al. [14]	Hydrocortisone plus Fludrocortisone for Adults with Septic Shock	Lower 90-day all-cause mortality in treatment group with accelerated resolution of multi organ failure
8	Venkatesh et al. [5]	Adjunctive Glucocorticoid therapy in patients with Septic Shock	Faster resolution of septic shock, shorter duration of mechanical ventilation in the Hydrocortisone group. No difference in the 90-day mortality, no. of days alive, rate of recurrence of shock or incidence of secondary infection.

Annane D, Sébille V, Bellissant E. Effect of low doses of corticosteroids in septic shock patients with or without early acute respiratory distress syndrome*. Crit Care Med. 2006;34(1):22–30.

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Arabi YM, Aljumah A, Dabbagh O, et al. Low-dose hydrocortisone in patients with cirrhosis and septic shock: a randomized controlled trial. Can Med Assoc J. 2010;182(18):1971–1977.

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Casserly B, Gerlach H, Phillips GS, et al. Low-dose steroids in adult septic shock: results of the surviving sepsis campaign. Intensive Care Med. 2012;38(12):1946–1954.

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Nazer L, AlNajjar T, Al-Shaer M, et al. Evaluating the effectiveness and safety of hydrocortisone therapy in cancer patients with septic shock. J Oncol Pharm Pract. 2014;21(4):274–279.

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Tongyoo S, Permpikul C, Mongkolpun W, et al. Hydrocortisone treatment in early sepsis- associated acute respiratory distress syndrome: results of a randomized controlled trial. Crit Care. 2016;20:1.

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Gibbison B, López-López JA, Higgins JPT, et al. Corticosteroids in septic shock: a systematic review and network meta-analysis. Crit Care. 2017;21:1.

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Annane D, Renault A, Brun-Buisson C, et al. Hydrocortisone plus fludrocortisone for adults with septic shock. N Engl J Med. 2018;378(9):809–818.

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Venkatesh B, Finfer S, Cohen J, et al. Adjunctive glucocorticoid therapy in patients with septic shock. N Engl J Med. 2018;378:797–808.

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