Abstract
Evidence-based analysis of clinical trials, concerning appropriateness of corticosteroids use and its efficacy in the treatment of septic shock, was performed. Results of pharmacoepidemiological study of corticosteroids use in Russian hospitals are presented. Author highlhts that empirical and disorderly prescribing prednisolone and dexamethasone to the patients with septic shock should be discouraged. Taking into account currently available evidence-based data on this topic, it is recommended to use only hydrocortisone at dose of 300 mg/day in the following subpopulations: patients with refractory septic shock or requiring for high-dose vasopressor support.
-
1.
Carlet J. From mega to more reasonable doses of corticosteroids: A decade to recreate hope. Crit Care Med 1999; 27:672-4.
-
2.
Johnson J.R., Davey W.N. Cortisone, corticotropin and antimicrobial therapy in tuberculosis in animals and man. Am Rev Tuberc 1954; 70:623-36.
-
3.
Hart P.D., Rees R.J. Enhancing effect of cortisone on tuberculosis in the mouse. Lancet 1950; 2:391-5.
-
4.
Spink W.W. ACTH and adrenocorticosteroids as therapeutic adjuncts in infectious diseases. N Engl J Med 1957; 257:979-83.
-
5.
Cavanagh D., McLeod A.G. Septic shock in obstetrics and gynecology. An evaluation of metaraminol therapy. Am J Obstet Gynecol 1966; 96:913-8.
-
6.
Nagler A., McConn R. The role of humoral factors in shock. In: Shock, clinical and experimental aspects. New York; 1976. p. 79-110.
-
7.
Raihgoff M., Melman K. Should corticosteroids be used in shock? Pred Clin North Am 1973; 57:1211-23.
-
8.
Rowe M., Marchildon M., Arango A., et al. The mechanisms of thrombocytopenia in gram-negative septicemia. Surgery 1978; 84(1):87-93.
-
9.
Blair E., Wise A., Mackay A.G. Gram-negative bacteremic shock: mechanisms and management. JAMA 1969; 207:333-6.
-
10.
Lucas C.E., Ledgerwood A.M. The cardiopulmonary response to massive doses of steroids in patients with septic shock. Arch Surg 1984; 119:537-41.
-
11.
Christy J.H. Treatment of gram-negative shock. Am J Med 1971; 50:77-88.
-
12.
Lillehei R.C., Dietzman R.H., Motsay G.J., et al. The pharmacologic approach to the treatment of shock. II. Diagnosis of shock and the plan of treatment. Geriatrics 1972; 27(8):81-94.
-
13.
Еналеева Д.Ш. Влияние массивных доз преднизолона на некоторые параметры гемодинамики и гемостаза при токсико-инфекционном шоке. Анестезиология и реаниматология 1978; (3):21-4.
-
14.
Schumer W. Steroids in the treatment of clinical septic shock. Ann Surg 1976; 184:333-41.
-
15.
Bone R.C., Fisher C.J. Jr., Clemmer T.P., et al. A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 1987; 317:653-8.
-
16.
The Veterans Administration Systemic Sepsis Cooperative Study Group. Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. N Engl J Med 1987; 317:659-65.
-
17.
Thompson W., Gurley H., Lutz B., et al. Inefficacy of corticosteroids in shock. Clin Rest 1976; 24:258A.
-
18.
Sprung C., Caralis P., Marcial E., et al. The effects of high-dose corticosteroids in patients with septic shock: a prospective, controlled study. N Engl J Med 1984; 311:1137-43.
-
19.
Luce J., Montgomery A., Marks J., et al. Ineffectiveness of high-dose methylprednisolone in preventing parenchymal lung injury and improving mortality in patients with septic shock. Am Rev Respir Dis 1988; 138:62-8.
-
20.
McConn R., Del Guercio L.R. Respiratory function of blood in the acutely ill patient and effect of steroids. Ann Surg 1971; 174:436-50.
-
21.
Лыткин М.И., Костин Э.Д., Костюченко А.Л., Терёшин И.М. Септический шок. Л.: Медицина; 1980. 240 с.
-
22.
Wilson R.F., Fischer R.R. The hemodynamic effects of massive steroids in clinical shock. Surg Gynecol Obstet 1968; 127:769-76.
-
23.
Петров И.Р., Бондина В.А. Патогенез и лечение осложнений, обусловленных переливанием инфицированной крови. Проблемы гематологии и переливания крови 1966; (3):18-24.
-
24.
McCabe W.R. Gram-negative bacteremia. Adv Intern Med 1974; 19:135-58.
-
25.
Bennett I.L., Finland M., Hamburger M., et al. The effectiveness of hydrocortisone in the management of severe infection. JAMA 1963; 183:462-5.
-
26.
Cronin L., Cook D.J., Carlet J., et al. Corticosteroid treatment for sepsis: a critical appraisal and meta-analysis of the literature. Crit Care Med 1995; 23:1430-9.
-
27.
Klastersky J., Cappel R., Debusscher L. Effectiveness of betamethasone in management of severe infections. A double-blind study. N Engl J Med 1971; 284:1248-50.
-
28.
Carlet J. Steroid therapy during septic shock: a second birth? Advances in sepsis 2001; 1:93-6.
-
29.
Briegel J., Kellermann W., Forst H., et al. Low-dose hydrocortisone infusion attenuates the systemic inflammatory response syndrome. The Phospholipase A2 Study Group. Clin Investig 1994; 72:782-7.
-
30.
Jurney T.H., Cockrell J.L. Jr., Lindberg J.S., et al. Spectrum of serum cortisol response to ACTH in ICU patients. Correlation with degree of illness and mortality. Chest 1987; 92:292-5.
-
31.
Rothwell P.M., Udwadia Z.F., Lawler P.G. Cortisol response to corticotropin and survival in septic shock. Lancet 1991; 337:582-3.
-
32.
Span L., Hermus A., Bartelink A., et al. Adrenocortical function: an indicator of severity of disease and survival in chronic critically ill patients. Intensive Care Med 1992; 18:93-6.
-
33.
Moran J., Chapman M., O’Fathartaigh M., et al. Hypocortisolaemia and adrenocortical responsiveness at onset of septic shock. Intensive Care Med 1994; 20:48995.
-
34.
Annane D., Bellissant E., Sebille V., et al. Impaired pressor sensitivity to noradrenaline in septic shock patients with and without impaired adrenal function reserve. Br J Clin Pharmacol 1998; 46:589-97.
-
35.
Finlay W., McKee J. Serum cortisol levels in severely stressed patients. Lancet 1982; 1:1414-5.
-
36.
Keh D., Boehnke T., Weber-Cartens S., et al. Immunological and hemodynamic effects of “low-dose” hydrocortisone in septic shock: a double-blind, randomized, placebo-controlled, crossover study. Am J Respir Crit Care Med 2003; 167:512-20.
-
37.
Prigent H., Maxime V., Annane D. Clinical review: Corticotherapy in sepsis. Crit Care 2004; 8:122-9.
-
38.
McKee J., Finlay W. Cortisol replacement in severely stressed patients. Lancet 1983; 1:484.
-
39.
Chrousos G.P. The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. N Engl J Med 1995; 332:1351-62.
-
40.
Molijn G., Spek J., van Uffelen J., et al. Differential adaptation of glucocorticoid sensitivity of peripheral blood mononuclear leukocytes in patients with sepsis and septic shock. J Clin Endocrinol Metab 1995; 80:1799-803.
-
41.
Oppert M., Reinicke A., Graf K., et al. Plasma cortisol levels before and during “low-dose” hydrocortisone therapy and their relationship to hemodynamic improvement in patients with septic shock. Intensive Care Med 1999; 26:1747-55.
-
42.
Dieulafoye G. Manauel de pathologie interne. Paris; 1904.
-
43.
Briegel J., Forst H., Hellinger H., Haller M. Contribution of cortisol deficiency to septic shock. Lancet 1991; 338:507-8.
-
44.
Thomas J.P., el-Shaboury A. Aldosteron secretion in steroid-treated patients with adrenal suppression. Lancet 1971; 1:623-5.
-
45.
Bollaert P., Charpentier C., Levy B., et al. Reversal of late septic shock with supraphysiologic doses of hydrocortisone. Crit Care Med 1998; 26:645-50.
-
46.
Briegel J., Forst H., Haller M., et al. Stress doses of hydrocortisone reverse hyperdynamic septic shock: a prospective, randomized, double-blind, single-center study. Crit Care Med 1999; 27:723-32.
-
47.
Annane D., Sebille V., Charpentier C., et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288:862-71.
-
48.
Graf J., Doig G.S., Cook D., Vincent J.L., Sibbald W. Randomized, controlled clinical trials in sepsis: has methodological quality improved over time? Crit Care Med 2002; 30:461-72.
-
49.
Almawi W.Y. Molecular mechanisms of glucocorticoid effects. Mod Asp Immunobiol 2001; 2:78-82.
-
50.
Руднов В.А., Ложкин С.Н., Галеев Ф.С., и соавт. Фармакоэпидемиологический анализ лечения сепсиса в отделениях реанимации и интенсивной терапии. Клин микробиол антимикроб химиотер 2003; 2:144-52.