• J A Llompart-Pou, J M Raurich, J Ibáñez, M Riesco, and J I Ayestarán.
• Servicio de Medicina Intensiva. Hospital Universitario Son Dureta. Palma de Mallorca. Islas Baleares. España. jallompart@hsd.es
• Med Intensiva. 2008 Nov 1; 32 (8): 385-90.

ObjectiveTreatment with low dose steroids (LDST) in patients with septic shock treated with vasoactive agents has been related to earlier shock reversal. Patients with low baseline cortisol and a blunted response to the corticotropin test are more likely to benefit from LDST, so we compared the immediate hemodynamic response in patients with septic shock who received LDST with that of those who did not receive LDST.DesignRetrospective study.ScopeIntensive Care Unit (ICU) of a tertiary university hospital.PatientsWe studied 96 patients admitted to the ICU. Patients were classified in two groups of 48 patients: group A received LDST and group B did not; patients were matched according to baseline cortisol levels and norepinephrine requirements.InterventionsAll patients underwent a short corticotropin test (250 microg ACTH) within 72 h of septic shock onset.Main Variables Of InterestBaseline cortisol, delta cortisol, peak cortisol, norepinephrine reduction after LDST, and duration of shock.ResultsThe two groups were comparable: baseline and stimulated cortisol levels before corticotropin test were similar, and there were no differences in the norepinephrine dose before and 24 h after testing adrenal response (p = 0.98 and p = 0.53, respectively). Norepinephrine reduction at 24 h after testing was not correlated with baseline cortisol or with adrenal response to the corticotropin test.ConclusionsLDST was not associated to improved 24-hour hemodynamic response, irrespective of the baseline and stimulated cortisol levels.

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