Corticosteroids in Endotoxin Shock: Effect on Renal Vasomotion

DESPITE ESPITE antibiotics and a large variety of adjunctive agents, the mortality in septic shock ranges from 11% 1 to 82% 2 with an average survival rate of about 50%. 3 Despite the advantage of treating predominantly young patients, our mortality has remained at about 30%. 4 In the face of results such as these, it is evident that the present methods of treatment require urgent reevaluation. In particular, more attention must be directed to the pathogenesis of the shock process and to the mechanism of action of the drugs used in treatment. Several investigators have recommended the use of large doses of corticosteroids in the treatment of endotoxin shock. 5-11 A retrospective study by Shubin and Weil on 169 patients in shock caused by gram-negative bacteria revealed an appreciably better survival rate among the patients receiving pharmacological doses of steroids. 2 The mechanisms by which corticosteroids increase systemic blood