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- David R Williamson and Marc Lapointe.
- Pharmacy Faculty, University of Montreal, Department of Pharmacy Services, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada. david.williamson@umontreal.ca
- Pharmacotherapy. 2003 Apr 1;23(4):514-25.
AbstractSevere sepsis is the leading cause of death among patients in intensive care units. Recombinant activated protein C is the only substance known to directly improve morbidity and mortality. Adrenal insufficiency occurs frequently in patients with sepsis and is associated with poor outcome. Although high-dose glucocorticoids have not positively affected clinical outcome, small trials in which low-dose glucocorticoids were administered to patients with septic shock and relative adrenal insufficiency have shown decreased mortality. The main effect of glucocorticoids in low-doses apparently is exerted through correction of suppression of the hypothalamic-pituitary-adrenal axis. However, the therapeutic benefits of glucocorticoids may be related to their antiinflammatory properties and endogenous catecholamine-enhancing effects.
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