Critical care specialists debate best management strategy for sepsis and septic shock

In a new Annals ‘Beyond the Guideline’s feature, two critical care specialists discuss and debate conditional guideline recommendations on using lactate to guide resuscitation, the use of balanced crystalloids versus normal saline, and the use of corticosteroids for management of sepsis and septic shock. All ‘Beyond the Guidelines’ features are based on the Department of Medicine Grand Rounds at Beth Israel Deaconess Medical Center (BIDMC) in Boston and include print, video, and educational components published in Annals of Internal Medicine.

Early Steroids Improve Outcomes in Patients with Septic Shock

Some critically ill patients with septic shock need medications called vasopressors to correct dangerously low blood pressure. When high doses of vasopressors are needed or blood pressure isn’t responding well, the steroid hydrocortisone is often used. In this situation, earlier treatment with hydrocortisone reduces the risk of death and other adverse outcomes, reports a study in SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches, Official Journal of the Shock Society. The journal is published in the Lippincott portfolio by Wolters Kluwer.