Do Corticosteroids Improve Mortality or Shock Reversal in Patients With Septic Shock?

Authors included 22 studies in the network meta-analysis, excluding 11 from the 2015 Cochrane review. Hydrocortisone infusion demonstrated superior shock reversal compared with placebo (OR 3.68; 95% CI 1.52 to 8.93) (Table). Methylprednisolone bolus was less likely to reverse shock than hydrocortisone bolus (OR 0.37; 95% CI 0.19 to 0.72). No regimens demonstrated superiority for the outcomes of mortality at 28 days, hospital mortality, ICU mortality, or incidence of superinfection. Methylprednisolone use trended toward increased mortality compared with dexamethasone (OR 5.71; 95% CI 0.99 to 32.9).

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