Current Use of Steroids in Critical Care.

Septic shock is characterized by an uncontrolled systemic inflammatory response that contributes to organ dysfunction, failure and eventually death. The importance of the adrenal glands for survival under conditions of physiologic stress has been known since the early 20th century. Clinical studies explored the potential therapeutic role of corticosteroids in the treatment of sepsis and septic shock. Despite controversies on the benefit-to-risk ratio, they are widely used. The longstanding adoption of corticosteroids in the treatment of severe sepsis likely relies on the prompt reversal of septic shock often seen at the bedside. This current review was designed to provide readers with a clear understanding and rationale for using corticosteroids, while presenting a review of the Surviving Sepsis Guidelines and the results from the implementation of the Surviving Sepsis Campaign.