Low dose steroid treatment for septic shock and effects of this treatment on vasopressor requirement

In this study, we aimed to invastigate the low dose steroid treatment (200mg ? 300mg / day) and its effects on vasopressor requirement in patients with septic shock.After obtaining Ethical permission, the documentes of patients that admitted to Karadeniz Technical University Faculty of Medicine Farabi Hospital Anestheology and Reanimation ICU (Intensive Care Unite) between April 2007 to January 2009 were searched retrospectively. Sixty patients who were sixteen years old or older and systolic arterial blood pressure lower than 90 mmHg for at least one hour despite adequate fluid replacement and vasopressor support, were found and enrolled in the study. 29 of patients were received low dose steroid therapy and 31 of them not received. And we categorized patients into this two group. Demografic datas, length of stay in ICU, ventilatory support time, cause of ICU admission, prior or preexisting disease, APACHE II and SOFA scores, site of infection, microbiologic examination results, performed intravenous antibiotheraphy, reversal of septic shock and its time, mortality in ICU and its time with complications of steroid treatment like süperenfection and gastrointestinal bleeding of these patients were recorded. Mean arterial pressures, heart rates, central venous pressures, vasopressor (norepinephrine, dopamine and dobutamine) doses, leukocytes, arterial lactate, CRP, procalsitonin, blood glucose levels and received insulin doses and growing number of organ failure follow up periods were determined before and recorded. The data were statistically analyzed.As a result, low-dose steroid therapy was found to reduce vasopressor support requirement in patients with vasopressor dependent septic shock.