Hydrocortisone in septic shock, ARDS and severe pneumonia

Abstract

Hydrocortisone has decreased shock duration and improved outcome in patients with septic shock. More recent trials have suggested a positive effect of this so-called replacement therapy in severe pneumonia and sepsis. The results of hydrocortisone during ARDS are equivocal. The mechanism responsible for the hydrocortisone-induced benefit remains uncertain, but improved vasopressor response and the restrain of exaggerated systemic inflammation may be important. Adrenal insufficient screening should be performed in every ICU patient with severe disease.