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Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science

Specialty

Emergency Medicine

Advisor

Nancy Reid

Abstract

Sepsis is the body’s overwhelming response to infection, which can lead to tissue damage, organ failure, amputations, and death. Strikingly, sepsis is the leading cause of death in U.S. hospitals.1 Given that nearly a third of patients that are admitted to the intensive care unit (ICU) have some form of circulatory shock makes this a very relevant topic in hospital and critical care medicine today. Moreover, the majority of circulatory shock is distributive shock from sepsis.2

For adult patients who present in or develop sepsis or septic shock, the debate around the utility and role that steroids play in the course of therapy, inherently, seems to surface. Sepsis, septic shock, and the associated therapies are topics at the forefront of hospital and critical care medicine discussions. That said, positions on the use of intravenous (IV) steroids outlined in the literature, as it pertains to sepsis, namely septic shock, are conflicting. Reviewed are comparisons of clinical outcomes of those patients that receive IV steroids as part of their treatment regimen compared to those that do not. The purpose of this publication is to not only bring awareness to sepsis and septic shock, but to briefly review the approach to management of these patients. Specifically, this publication seeks to answer the question regarding the clinical utility of steroids in the treatment of patients with sepsis or septic shock. Despite years of controversial debate around the use of steroids in this patient population, there remains a divide. The question remains, does the research evidence suggest a treatment benefit for adult patients with severe sepsis, namely septic shock, with the use of IV steroids compared to those patients’ clinical outcomes who do not receive IV steroids? Simply stated, given the available data outlined below, the use of steroids in the treatment of sepsis, namely septic shock, remains controversial and is not supported strictly based on mortality benefit.3

Keywords: Sepsis, Septic shock, Steroids

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