Jones AE1, Puskarich MA2. The Surviving Sepsis Campaign guidelines 2012: update for emergency physicians. Ann Emerg Med. 2014 Jan;63(1):35-47.
- Do not use intravenous hydrocortisone as a treatment of adult septic shock patients if adequate fluid resuscitation and vasopressor therapy are able to restore hemodynamic stability. If this is not achievable, we suggest intravenous hydrocortisone alone at a dose of 200 mg per day (grade 2C).
Do not use adrenocorticotropic hormone (ACTH) stimulation test to identify the subset of adults with septic shock who should receive hydrocortisone (grade 2B).
Taper the treated patient from steroid therapy when vasopressors are no longer required (grade 2D).
- Corticosteroids should not be administered for the treatment of sepsis in the absence of shock (grade 1D).
- When low-dose corticosteroids are given, we suggest using continuous infusion rather than repetitive bolus injections (grade 2D).