Administration of corticosteroids to patients with severe sepsis and improvement of in-hospital mortality: A systematic review
Abstract
Objective: To determine if there is scientific evidence to demonstrate a beneficial effect of corticosteroid treatment in patients with severe sepsis or septic shock. Also, to indicate the best clinical practice in the use of corticosteroids for the treatment of patients with severe sepsis or septic shock. We propose to determine the profile of the septic patient with critical illness that can benefit from the administration of corticosteroids for their treatment.
Methodology: Search in databases of great evidence, establishing criteria of inclusion and exclusion to obtain a greater specificity of the subject. In the selection, the premises of the CASPe program were followed, and 9 articles were included in our systematic review.
Results and conclusions: Most of the evidence shows that the administration of corticosteroids has a benefit in the reversion of shock, but does not decrease the mortality of patients. It was observed that patients who benefit from this type of treatment are those that are more critical, with APACHE II scores higher. On the other hand, the literature shows better results in relation to the benefit of this treatment, if it is started early in patients candidates for such treatment, and the best way to administer them is in a continuous infusion. A possible cause of the heterogeneity in the results regarding the benefits of corticosteroid administration could be related to a genetic variation, as shown by Schäfer et al.
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