What are the new guidelines for administering steroids in the management of patients with sepsis?

Jones AE1, Puskarich MA2. The Surviving Sepsis Campaign guidelines 2012: update for emergency physicians. Ann Emerg Med. 2014 Jan;63(1):35-47.

Recommendations:

  • 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).
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About Amy

Clinical Informationist at EUH Branch Library
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