Interstitial, Inflammatory, And Occupational Lung DiseaseCorticosteroids in Severe SepsisAnnane, Djillali MD, PhD*; Bollaert, Pierre-Edouard MD†; Lagente, Vincent PharmD‡; Bellissant, Eric MD, PhD§Author Information *Service de Réanimation Médicale, Hôpital Raymond Poincaré, Faculté de Médecine Paris-Ouest, Université Paris V, Garches, France; †Service de Réanimation Médicale, Hôpital Central, Faculté de Médecine de Nancy, Université Nancy I, Nancy, France; ‡Laboratoire de Pharmacodynamie et de Pharmacologie Moléculaire, Faculté de Pharmacie, Université de Rennes I, Rennes France; and the §Laboratoire de Pharmacologie Expérimentale et Clinique, Faculté de Médecine, Université de Rennes I, Rennes, Address correspondence to: Djillali Annane, MD, PhD, Service de Réanimation Médicale, Hôpital Raymond Poincaré, 104 boulevard Raymond Poincaré, 92380 Garches, France. Address e-mail to: [email protected] Clinical Pulmonary Medicine: September 2001 - Volume 8 - Issue 5 - p 273-278 Buy Abstract Septic shock remains one of the leading causes of death in intensive care units. Although our understanding of the mechanisms of inflammation has progressed during the last two decades, the drugs developed toward the specific targets of the cytokine cascade have failed to improve patients’ survival. Corticosteroids were the first antiinflammatory drugs tested in randomized controlled trials. Administered during short courses and at high doses, they did not induce any beneficial effect. However, recent findings on the mechanisms of action of steroids and on the mechanisms of host response to septic insult have led to a reappraisal of the use of these drugs in septic shock. Several randomized controlled trials have evaluated the efficacy and safety of prolonged treatments with low doses of hydrocortisone in severe sepsis. These trials strongly suggest that this new strategy of administration of corticosteroids reduces the morbidity of septic shock and may favorably affect survival. © 2001 Lippincott Williams & Wilkins, Inc.