The role of steroids in treating septic shock

Grover, Vikas; Handy, Jonathan

doi:10.1111/j.1365-2044.2011.07026.x

Cited by 3 publications

(1 citation statement)

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“…There are two main rationales for the use of corticosteroids in septic shock: immunomodulation; and maintenance of vasomotor tone [59]. Corticosteroids may downregulate pro‐inflammatory cytokines, including Il‐6 and TNF‐⍺, suppress activation of the innate immune system, and have a permissive effect in the maintenance of vasomotor tone.…”

Section: Corticosteroidsmentioning

confidence: 99%

Adjunctive treatments for the management of septic shock – a narrative review of the current evidence

et al. 2021

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Summary Septic shock is a leading cause of death and morbidity worldwide. The cornerstones of management include prompt identification of sepsis, early initiation of antibiotic therapy, adequate fluid resuscitation and organ support. Over the past two decades, there have been considerable improvements in our understanding of the pathophysiology of sepsis and the host response, including regulation of inflammation, endothelial disruption and impaired immunity. This has offered opportunities for innovative adjunctive treatments such as vitamin C, corticosteroids and beta‐blockers. Some of these approaches have shown promising results in early phase trials in humans, while others, such as corticosteroids, have been tested in large, international, multicentre randomised controlled trials. Contemporary guidelines make a weak recommendation for the use of corticosteroids to reduce mortality in sepsis and septic shock. Vitamin C, despite showing initial promise in observational studies, has so far not been shown to be clinically effective in randomised trials. Beta‐blocker therapy may have beneficial cardiac and non‐cardiac effects in septic shock, but there is currently insufficient evidence to recommend their use for this condition. The results of ongoing randomised trials are awaited. Crucial to reducing heterogeneity in the trials of new sepsis treatments will be the concept of enrichment, which refers to the purposive selection of patients with clinical and biological characteristics that are likely to be responsive to the intervention being tested.

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Section: Corticosteroidsmentioning

confidence: 99%

Adjunctive treatments for the management of septic shock – a narrative review of the current evidence

et al. 2021

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Coagulopathy and Inflammation: An Overview of Blast Effects

Tarmey

Kirkman

2016

Blast Injury Science and Engineering

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