Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: The International Sepsis Forum’s controversies in sepsis: corticosteroids should be used to treat septic shock. | Available online http content 6 5 381 Commentary The International Sepsis Forum s controversies in sepsis corticosteroids should be used to treat septic shock Sergey Goodman1 and Charles L Sprung2 Senior physician Department of Anesthesiology and Critical Care Medicine Hadassah Hebrew University Medical Center The Hebrew University of Jerusalem Israel 2Director General Intensive Care Unit Department of Anesthesiology and Critical Care Medicine Hadassah Hebrew University Medical Center The Hebrew University of Jerusalem Israel Correspondence Charles L Sprung editorial@ Published online 17 July 2002 Critical Care 2002 6 381-383 This article is online at http content 6 5 381 2002 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X This article is based on a Pro-Con debate at the 31st Annual Congress of the Society of Critical Care Medicine SCCM San Diego California USA 26-30 January 2002 and may not necessarily reflect the actual opinion of the author. The presentation was supported by the International Sepsis Forum ISF . Abstract The use of corticosteroids in septic shock remains controversial. It has been demonstrated that high doses of steroids 30 mg kg methylprednisolone for short periods of time are not beneficial. More recent studies using smaller doses 200-300 mg day hydrocortisone for longer periods of time have shown beneficial effects. These positive effects have included reversal of shock trends toward decreased organ system dysfunction and decreased mortality. Based on the high proportion of patients who have relative adrenal insufficiency the benefits of low doses of steroids and the minimal risks steroids should be used to treat septic shock. Keywords corticosteroids relative adrenal insufficiency septic shock survival In the early 1980s we were big proponents of using corticosteroids in septic shock whereas in the late 1980s following publication of the findings of the Veterans Administration Systemic Sepsis
