Efficacy of corticosteroids on survival in patients with sepsis and septic shock: meta-analysis

Previous studies have recommended the use of low-dose corticosteroids in patients with septic shock. Specifically, response to corticotropin tests has been recognized as a prognostic factor in critically ill patients, especially in patients with no response to the corticotropin test. A recent large randomized controlled trial evaluating the efficacy of low-dose corticosteroids revealed no benefit on overall survival or in patients with no response to corticotropin in patients with severe sepsis and septic shock. Recently, recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients were published as consensus statements from an international task force by the American College of Critical Care Medicine [1]. However, some studies were not included in these statements.