What Is the Role of Steroids for Septic Shock in 2021?

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.

Distinct pulmonary and systemic effects of dexamethasone in severe COVID-19

“…Limited data are available about the compartmentalized biological effects of steroids in patients with ARDS, pneumonia, or sepsis due to causes other than COVID-19, and the role of corticosteroids to treat these conditions in patients remains uncertain. [22][23][24] Our analysis identifies dysregulated pathways potentially modified by dexamethasone therapy that could have potential therapeutic relevance in other causes of critical illness 25 .…”

Spider Bite-Induced Facial Nerve Palsy

“…So, antibiotics and debridement as needed would be a reasonable first step. Whichever the case, the use of intravenous steroids is useful for both idiopathic cases of palsy and facial paralysis associated with infection and sepsis [ 13 , 14 ]. It is nevertheless important to mention that in this case, the use of intravenous steroids resulted in no clear improvement based on available information.…”