Utility of corticosteroids in septic shock

Background: Septic shock is a critical condition characterized by life-threatening circulatory and cellular/metabolic abnormalities. Despite advances in supportive care, mortality remains high. The use of corticosteroids as adjunctive therapy has been a subject of ongoing debate.

Objective: To evaluate the role, benefits, and potential risks associated with corticosteroid therapy in patients with septic shock.

Methods: A narrative review of the literature was conducted, focusing on clinical trials and meta-analyses published over the last decade that assess the efficacy and safety of corticosteroids in septic shock.

Results: Evidence suggests that low-dose corticosteroids may help reverse shock more quickly, reduce vasopressor dependency, and shorten ICU stay in certain subgroups of patients. However, the impact on overall mortality remains uncertain. Adverse effects, including hyperglycemia and secondary infections, must also be considered.

Conclusion: Corticosteroids can be a useful adjunctive therapy in the management of septic shock, particularly in patients with refractory hypotension. Further research is needed to define optimal timing, dosage, and patient selection to maximize benefits and minimize risks.