Corticosteroids for septic shock: what to do now?

Paul E. Marik


In a recent edition of the New England Journal of Medicine, two large randomized controlled trials report on the use of corticosteroids (hydrocortisone) for the treatment of septic shock (1,2). The Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial failed to show a mortality benefit while the Activated Protein C and Corticosteroids for Human Septic Shock (APROCCHSS) trial showed a significant reduction in 90-day mortality.