The International Sepsis Forum's controversies in sepsis: corticosteroids should not be routinely used to treat septic shock

doi:10.1186/cc1531

Critical Care
Volume 6
Issue 5

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Commentary

The International Sepsis Forum's controversies in sepsis: corticosteroids should not be routinely used to treat septic shock

Gordon Bernard

Professor of Medicine, Director, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University, Nashville, Tennessee, USA

author email corresponding author email

Critical Care 2002, 6:384-386doi:10.1186/cc1531


Published:	17 July 2002

This article is based on a presentation at the 31st Annual Congress of the Society of Critical Care Medicine (SCCM), San Diego, California, USA, 26-30 January 2002. The presentation was supported by the International Sepsis Forum (ISF). See related Commentary: http://ccforum.com/content/6/5/381

Abstract

Corticosteroid treatment of severe sepsis has been one of the most controversial clinical issues in critical care. In fact, few agents can claim to have been evaluated in scores of studies spanning 3–4 decades. Yet, convincing proof that corticosteroids are useful pharmacologic agents in the treatment of this major clinical problem remains elusive. Recently, interest has resurfaced but this time the focus is on a steroid replacement approach for what has now been termed "relative adrenal insufficiency" rather than relying on the pharmacologic effects of steroids. This route holds promise, but proof remains lacking.