Corticosteroids and human recombinant activated protein C for septic shock

Clin Chest Med. 2008 Dec;29(4):705-12, x. doi: 10.1016/j.ccm.2008.06.009.

Abstract

This article summarizes the current knowledge on the benefit/risk profile from the use of low-dose corticosteroids and activated protein C in treating septic shock. Physicians should consider using low-dose corticosteroids and drotrecogin alpha activated in the treatment of patients who have vasopressor-dependent septic shock with persistent signs of hypoperfusion, organ dysfunction, or hypotension. The optimal timing for initiating these treatments is from 6 to 24 hours from onset of shock. When patients are receiving these drugs, physicians should systematically screen for superinfection and serious bleeding events.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • APACHE
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Fibrinolytic Agents / adverse effects
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Multicenter Studies as Topic
  • Multiple Organ Failure / drug therapy
  • Multiple Organ Failure / mortality
  • Protein C / adverse effects
  • Protein C / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use
  • Shock, Septic / drug therapy*
  • Shock, Septic / mortality
  • Survival Rate

Substances

  • Adrenal Cortex Hormones
  • Fibrinolytic Agents
  • Protein C
  • Recombinant Proteins
  • drotrecogin alfa activated