Adjunctive Steroid Therapy for Treatment of Pediatric Septic Shock

Abstract

Septic shock remains the major cause of childhood morbidity and mortality worldwide. Although early sepsis recognition, fluid resuscitation, timely administration of antimicrobials, and vasoactive-inotropic drug infusions are all key to achieving good sepsis outcomes, therapy using various steroid drug classes remains an attractive adjunctive intervention to minimize the duration of septic shock and transition to multiple organ dysfunction syndrome. All steroid drug classes possess biological plausibility to affect a beneficial clinical effect among children with septic shock, but none has undergone rigorous, prospective assessment in a large, high-quality pediatric interventional trial.

Keywords: 17β-estradiol; Adjunctive sepsis therapy; Aldosterone; Cortisol; Glucocorticoids/corticosteroids; Hydrocortisone; Oxandrolone; Septic shock.