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martes, 11 de octubre de 2016

Corticosteroids in Sepsis

emDocs - October 10, 2016 - Author: Long B - Edited by: Santistevan J and Koyfman A
  • Sepsis management requires early recognition, fluid resuscitation, source control, broad spectrum antimicrobials, and vasopressors for those not responsive to IV fluids.
  • Patients with septic shock unresponsive to fluid and vasopressor resuscitation warrant further management and consideration of other disease states.
  • The pathophysiology of sepsis may include loss of vasomotor tone and relative adrenal insufficiency.
  • High-dose corticosteroids may result in patient harm, but physiologic, or low-dose, corticosteroids may be used to decrease the need for vasopressors.
  • Most current meta-analyses do not demonstrate a mortality benefit with steroids. The Surviving Sepsis Guidelines advise consideration of corticosteroids in patients with vasopressor and fluid resistant septic shock.
  • Corticosteroids may decrease need for vasopressors and improve perfusion."