Shock

CIRCI

critical illness-related corticosteroid insufficiency

C. What is the recommended dose and duration of treatment among hospitalized adult patients with septic shock treated with corticosteroids?

Recommendation: If using corticosteroids for septic shock, we suggest using long course and low dose (e.g., IV hydrocortisone < 400 mg/day for at ≥ 3 days at full dose) rather than high dose and short course in adult patients with septic shock (conditional recommendation, low quality of evidence).

Annane, Djillali MD, PhD1; Pastores, Stephen M. MD, FCCM2; Rochwerg, Bram MD3; Arlt, Wiebke MD, DSc, FRCP4; Balk, Robert A. MD, MCCM5; Beishuizen, Albertus MD, PhD6; Briegel, Josef MD, PhD7; Carcillo, Joseph MD, FCCM8; Christ-Crain, Mirjam MD, PhD9; Cooper, Mark S. MD10; Marik, Paul E. MD, FCCM11; Umberto Meduri, Gianfranco MD12; Olsen, Keith M. PharmD, FCCM13; Rodgers, Sophia C. RN, MSN, ACNP, FCCM14; Russell, James A. MD15; Van den Berghe, Greet MD, PhD16. Guidelines for the Diagnosis and Management of Critical Illness-Related Corticosteroid Insufficiency (CIRCI) in Critically Ill Patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Critical Care Medicine 45(12):p 2078-2088, December 2017. | DOI: 10.1097/CCM.0000000000002737