PMID: 15238370Jul 9, 2004Paper

Meta-analysis: the effect of steroids on survival and shock during sepsis depends on the dose

Annals of Internal Medicine
Peter C MinneciCharles Natanson

Abstract

Previous meta-analyses demonstrated that high-dose glucocorticoids were not beneficial in sepsis. Recently, lower-dose glucocorticoids have been studied. To compare recent trials of glucocorticoids for sepsis with previous glucocorticoid trials. Systematic MEDLINE search for studies published between 1988 and 2003. Randomized, controlled trials of sepsis that examined the effects of glucocorticoids on survival or vasopressor requirements. Two investigators independently collected data on patient and study characteristics, treatment interventions, and outcomes. The 5 included trials revealed a consistent and beneficial effect of glucocorticoids on survival (I2 = 0%; relative benefit, 1.23, [95% CI, 1.01 to 1.50]; P = 0.036) and shock reversal (I2 = 0%; relative benefit, 1.71 [CI, 1.29 to 2.26]; P < 0.001). These effects were the same regardless of adrenal function. In contrast, 8 trials published before 1989 demonstrated a survival disadvantage with steroid treatment (I2 = 14%; relative benefit, 0.89 [CI, 0.82 to 0.97]; P = 0.008). In comparison with the earlier trials, the more recent trials administered steroids later after patients met enrollment criteria (median, 23 hours vs. <2 hours; P = 0.02), for longer courses (6 days v...Continue Reading

Citations

Oct 8, 2008·Intensive Care Medicine·Daniel A SweeneyCharles Natanson
Aug 5, 2009·Intensive Care Medicine·Brian H CuthbertsonYoram G Weiss
Nov 1, 2007·Reviews in Endocrine & Metabolic Disorders·Shekhar VenkataramanSelma Feldman Witchel
Aug 29, 2006·Current Infectious Disease Reports·Ismail Cinel, R Phillip Dellinger
Aug 9, 2008·Current Infectious Disease Reports·Didier KehOlaf Ahlers
Aug 31, 2013·Current Infectious Disease Reports·Amisha V BarochiaPeter Q Eichacker
Dec 17, 2010·Clinical Reviews in Allergy & Immunology·Christian PowellM Eric Gershwin
Aug 26, 2006·Nature Clinical Practice. Endocrinology & Metabolism·Ilse VanhorebeekGreet Van den Berghe
May 9, 2008·The New England Journal of Medicine·Mark R Daley
Jan 11, 2008·The New England Journal of Medicine·Simon Finfer
Jan 11, 2008·The New England Journal of Medicine·Charles L SprungUNKNOWN CORTICUS Study Group
Apr 13, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andre C Kalil
May 18, 2013·Journal of Interferon & Cytokine Research : the Official Journal of the International Society for Interferon and Cytokine Research·Younes J ErrahaliHenry J Lee
Nov 3, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·O PenackUNKNOWN German Society of Hematology and Oncology
May 29, 2009·British Journal of Anaesthesia·N R Webster, H F Galley
Oct 11, 2005·Critical Care Medicine·Pejman CohanDaniel F Kelly
May 10, 2005·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Mark W Hall
Apr 13, 2005·The Journal of Trauma·Katherine J DeansPeter C Minneci
Apr 11, 2008·Critical Care Medicine·Sean M Bagshaw, R T Noel Gibney
Dec 4, 2008·Critical Care Medicine·Claudio M MartinUNKNOWN STAR Registry Investigators
Dec 18, 2009·Critical Care Medicine·Daniel A SweeneyEllen N Behrend
Dec 24, 2009·Critical Care Medicine·Amisha V BarochiaPeter Q Eichacker
Sep 20, 2011·Critical Care Medicine·Caitlin W HicksCharles Natanson
Dec 6, 2008·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Harsha T ValoorM Jayashree
Mar 28, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Meredith AllenDuncan Macrae
Aug 19, 2008·Southern Medical Journal·Robert B Sanda, Omer A Omer
Jun 17, 2008·Journal of Gastroenterology and Hepatology·Reiner WiestRainer Straub
May 29, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·K Z VardakasM E Falagas
Jan 19, 2006·Clinical Microbiology Reviews·Lee H Harrison
Dec 24, 2013·Mediators of Inflammation·Felinda ArianiJieming Qu
Sep 17, 2005·Neuroimmunomodulation·Ilia J ElenkovGeorge P Chrousos
Nov 24, 2004·American Journal of Respiratory and Critical Care Medicine·Marco ConfalonieriG Umberto Meduri
Oct 22, 2005·American Journal of Respiratory and Critical Care Medicine·Jean-Louis Vincent, Edward Abraham
Mar 4, 2006·American Journal of Respiratory and Critical Care Medicine·Stephanie NonasKonstantin G Birukov

❮ Previous
Next ❯

Related Concepts

Related Feeds

Addison Disease

Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Discover the latest research on Addison's disease here.