Are Steroids for Septic Shock an Absolutely Yes, Absolute No, or 50-50?
Corticosteroids are a class of drugs that are involved in regulation of various physiological processes such as immune response, regulation of inflammatory processes, carbohydrate, and protein metabolism as well as behavior. Corticosteroids are used in management of various conditions that involves abnormal immune and inflammatory encompassing almost all fields of medicine such as rheumatology, hematology, dermatology, ophthalmology, and gastroenterology to name few. However, there is still an ongoing debate regarding efficacy of steroids in management of septic shock. The efficacy of high dose, short-term administration of steroids vs low dose for prolonged time period is controversial. The high-dose regimen is associated with poor prognosis and increased likelihood of development of complications. In case of severe stress approaching neurological impairment, steroids are proven to have benefits against development of post-traumatic stress disorder. Low-dose steroids reduces risk of delirium secondary to critical illness. In field of surgery, high-dose steroids are not recommended due to delayed wound healing and increased chances of wound site infections. However, low-dose pre-operative regimen is effective to reduce peri-operative and post-operative inflammation, thereby, reducing morbidity and mortality. Administration of corticosteroids are not proven advantageous for management of sepsis and septic shock. However, administering corticosteroids in septic shock is not harmful either. Corticosteroids therapy can be used as an adjunct, along with other immunity booster substances such as vitamin C to improve patients’ outcome. Source: Steroids for sepsis: yes, no or maybe https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949415/ Image via https://www.cbc.ca/player/play/1784289347868
