BMJ  2004;329 (28 August), doi:10.1136/bmj.329.7464.0-a

Corticosteroids reduce mortality in intensive care

Long courses of corticosteroids may reduce mortality in patients who have severe sepsis and septic shock. Reviewing 16 trials on 2063 patients, Annane and colleagues (p 480) found that corticosteroid did not change mortality at 28 days or hospital mortality. However, those patients who had low dose hydrocortisone ( 300 mg) for at least five days were more likely to survive, without increased risk of gastroduodenal bleeding, superinfection, or hyperglycaemia, than those receiving a short course of corticosteroids or placebo. This treatment may be more effective in patients with impaired production of corticosteroids, say the authors.

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Corticosteroids for severe sepsis and septic shock: a systematic review and meta-analysis

Djillali Annane, Eric Bellissant, Pierre Edouard Bollaert, Josef Briegel, Didier Keh, and Yizhak Kupfer
BMJ 2004 329: 480. [Abstract] [Full Text] [PDF]

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