Commentary

The International Sepsis Forum's controversies in sepsis: corticosteroids should be used to treat septic shock

Sergey Goodman¹ and Charles L Sprung²

¹Senior physician, Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, The Hebrew University of Jerusalem, Israel

²Director, General Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, The Hebrew University of Jerusalem, Israel

author email corresponding author email

Critical Care 2002, 6:381-383doi:10.1186/cc1537

Published:	17 July 2002

This article is based on a Pro-Con debate at the 31st Annual Congress of the Society of Critical Care Medicine (SCCM; San Diego, California, USA, 26-30 January 2002), and may not necessarily reflect the actual opinion of the author. The presentation was supported by the International SepsisForum (ISF). See related Commentary: http://ccforum.com/content/6/5/384

Abstract

The use of corticosteroids in septic shock remains controversial. It has been demonstrated that high doses of steroids (30 mg/kg methylprednisolone) for short periods of time are not beneficial. More recent studies using smaller doses (200–300 mg/day hydrocortisone) for longer periods of time have shown beneficial effects. These positive effects have included reversal of shock, trends toward decreased organ system dysfunction and decreased mortality. Based on the high proportion of patients who have relative adrenal insufficiency, the benefits of low doses of steroids and the minimal risks, steroids should be used to treat septic shock.