Characterization of the use of corticosteroids in the treatment of sepsis or septic shock

Authors

  • Danielle Talarico Carreira Facultad de Medicina y Ciencias de la Salud, Universidad Abierta Interamericana. Argentina Author https://orcid.org/0009-0004-6621-6792
  • Anibal Danilo Farias Facultad de Medicina y Ciencias de la Salud, Universidad Abierta Interamericana. Argentina Author

DOI:

https://doi.org/10.62486/agsalud2025110

Keywords:

Corticosteroid, Sepsis, Septic Shock, Hospital Emergency, Treatment

Abstract

Introduction: sepsis and septic shock are currently a serious public health problem, as it is a disease with a high rate of complications and because it is one of the main causes of admission to the intensive care unit (ICU). In addition, in recent decades the number of patients diagnosed with sepsis is growing every year.

Objectives: to determine whether the implementation of corticosteroids in the basic treatment of patients who are in sepsis or suffering from septic shock brings benefits or harms.

Method: this systematic review is based on a thorough search in the Medline (Pubmed) and Google Scholar databases, the analysis of the publications was chosen between the years 2010 to 2024.

Result: according to the evidence found in the 20 articles reviewed, the use of corticosteroid therapy reduces the time in some patients who are in shock, mainly those who do not respond adequately to conventional vasopressin fluids and drugs. However, it is still under discussion whether these data can be interpreted as beneficial for patients in terms of mortality. And whether the benefits are the same for septic patients given the potential risks that corticosteroids cause to the immune system and the hyperglycemia evidenced in some studies.

Conclusion: The results of the systematic review and the cohort studies analyzed suggest that there are still many disagreements on the matter, but most recommend the use of corticosteroid therapy as part of the treatment of patients with septic shock and not in sepsis

References

1. Zamora Tapia ID, Poveda Paredes FX. Importance of sepsis diagnosis in the clinical laboratory. Salud, Ciencia y Tecnología [Internet]. 2024 Jan. 1 [cited 2024 Sep. 24];4:704. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/636

2. Rosero Freire DA, Urvina Paredes SP. Volumen plaquetario medio y su estrecha relación con las infecciones sépticas hospitalarias. Salud, Ciencia y Tecnología [Internet]. 25 de enero de 2023 [citado el 24 de septiembre de 2024];3:250. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/472

3. Verdesoto Herrera FE, Yánez Castro JL, Ordóñez Castillo TF. Main predictor scales of mortality associated with septic shock of abdominal origin in adults. Salud, Ciencia y Tecnología [Internet]. 2022 Dec. 31 [cited 2024 Sep. 24];2:209. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/70

4. Djillali A, Bellissant E, Edouard Bollaert P, Briegel J. Corticosteroids for treating sepsis. [Internet]. 2015 [citado 2024 Sep 21]. 6 (3). Disponible en: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002243.pub3/full

5. Rodríguez-Portelles AC, Céspedes Rómulo AM, Carvajal Choque R, Trujillo Pérez MP, Montenegro Salas DS, Jaimes I, et al. Aortic peak flow variation as a predictor of fluid responsiveness in pediatric septic shock patients under mechanical ventilation. Salud, Ciencia y Tecnología [Internet]. 2023 Dec. 31 [cited 2024 Sep. 24];3:584. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/238

6. Vanegas Contreras GM, Andrés Felipe Mercado González AFMG, Chango Azanza DX, Flores Siguenza JB, Vega Cobos M del C, Pinos Vázquez JF. Endocarditis infecciosa como causa de shock séptico en un paciente joven sin factores de riesgo. Informe de caso. Salud, Ciencia y Tecnología [Internet]. 3 de diciembre de 2022 [consultado el 24 de septiembre de 2024];2:191. Disponible en: https://sct.ageditor.ar/index.php/sct/article/view/95

7. Chrysostomos S. Early Administration of Hydrocortisone Replacement After the Advent of Septic Shock. [Internet]. 2014 [citado 2024 Sep 21]. Disponible en: https://journals.lww.com/ccmjournal/abst ract/2014/07000/early_administration_of_hydrocortisone_replacement.8.aspx

8. Castro Santos Neta AB, Honorato Chaves AC, Regagnan Dias L. Relações da corticoterapia no tratamento do choque séptico / Relationship of corticotherapy in the treatment of septic shock. [Internet]. 2020 [citado 2024 Sep 21]. Disponible en: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/7179

9. Contrael, Katlynd M, Killian, Alley J. Patrones de prescripción de hidrocortisona en el shock séptico. [Internet]. 2020 [citado 2024 Sep 21]. Disponible en: https://journals.lww.com/ccmjournal/abstract/2013/10000/prescribing_patterns_of_hydrocortisone_in_septic.6.aspx

10. Sousa Menezes JP, strela Melo A, Gondim Ferreira LV. A redução da morbimortalidade no choque séptico com o uso precoce de hidrocortisona. [Internet]. 2020 [citado 2024 Sep 21]. Disponible en: https://ojs.brazilianjournals.com.br/ojs/index.php/BRJD/article/view/62462

11. Maciel Teixeira LA, Souza Araújo SL, Lima de Almeida Santos JR.The use of corticosteroids in sepsis and septic shock: systematic review. [Internet]. 2020 [citado 2024 Sep 21]. Disponible en: file:///C:/Users/Alex/Documents/Downloads/1+BJD+16-03+DOI+135.pdf

12. Salles S, Sprovieri R, Bedrikow A. Síndrome da resposta inflamatória sistêmica/sepse 3/4 revisão e estudo da terminologia e fisiopatología. [Internet]. 2020 [citado 2024 Sep 21]. Disponible en: https://www.scielo.br/j/ramb/a/8gXyF6FgfmRdKc9ghfxQNrn/?format=html

Downloads

Published

2025-01-01

Issue

Section

Original

How to Cite

1.
Talarico Carreira D, Farias AD. Characterization of the use of corticosteroids in the treatment of sepsis or septic shock. AG Salud [Internet]. 2025 Jan. 1 [cited 2024 Dec. 2];3:110. Available from: https://agsalud.ageditor.org/index.php/agsalud/article/view/110