Evidence about the use of glucocorticoids as therapy for sepsis: an integrative literature review
DOI:
https://doi.org/10.33448/rsd-v11i2.26196Keywords:
Glucocorticoids; Sepsis; Intensive therapy.Abstract
Introduction: sepsis is a systemic inflammatory disease associated with an infection with severe manifestations that occurs throughout the body. However, this infection does not necessarily have to be everywhere in the body, it can be restricted to just one place, but cause an inflammatory response throughout the body to try to control the cause of the infection. Objective: to demonstrate the current evidence on the use of corticosteroids in the treatment of sepsis in patients hospitalized in intensive care units (ICUs). Methodology: this is a descriptive research of the integrative literature review type. The descriptors were crossed, in English: "sepsis", "hemodynamic", "corticosteroids" in Portuguese: "sepsis", "hemodynamics", "corticosteroids" and in Spanish: "sepsis", "hemodynamic", "corticosteroids", in the following databases: National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (Scielo), Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Virtual Health Library (BVS) and EBSCO Information Services. Results and discussion: treatment can be done with corticosteroids in order to attenuate and modify the inflammatory response, in addition to offering an affordable cost. However, some side effects and adequate forms of administration corroborate the fact that there are some controversies regarding the use of corticosteroids, such as hydrocortisone, for the treatment of patients with sepsis, even with satisfactory results. Final considerations: corticosteroids, especially hydrocortisone, can be used to treat patients with sepsis. According to the literature used, the results are satisfactory and costing is easy to adhere to. However, the use of these drugs, even with benefits, is still controversial, due to the side effects caused, the dosage and the form of administration. Thus, discussions on this subject exist.
References
de Mello, A. C. P. M., et al. (2011). Corticoterapia no choque séptico e sepse grave. Revista da Sociedade Brasileira de Terapia Intensiva, 9 (1), 50-53.
Ellender, T., et al. (2020). Updates in Sepsis Resuscitation. Emergency Medicine Clinics of North America, 38 (4), 807–818.
Fang, D., et al. (2019). Association of corticosteroid treatment with outcomes in adult patients with sepsis: a systematic review and meta-analysis. JAMA Internal Medicine, 179 (2), 213-223.
Fuji, T., et al. (2020). Metabolic support in sepsis: corticosteroids and vitamins: the why, the when, the how. Curr. Opin. Crit. Care, 26(4), 363-368.
Heming, N., et al. (2020). Sepsis in the critically ill patient: current and emerging management strategies. Expert Review of Anti-Infective Therapy, 7 (8), 1-11.
Lamontagne, F., et al. (2018). Corticosteroid therapy for sepsis: a clinical practice guideline. BMJ, 9 (7), 1-14.
Lian, X. J., et al. (2019). Reevaluating the Role of Corticosteroids in Septic Shock: An Updated Meta-Analysis of Randomized Controlled Trials. Biomed Res Int., 1 (8), 56-70.
Lin, H. Y. (2020). The severe COVID-19: a sepsis induced by viral infection? And its immunomodulatory therapy. Chinese Journal of Traumatology, 9 (6), 39-45.
Lu, X., et al. (2020). Efficacy and safety of corticosteroids for septic shock in immunocompromised patients: A cohort study from MIMIC. The American Journal of Emergency Medicine, 5 (8), 1-9.
Lobo, S. M., et al. (2019). Mortalidade por sepse no Brasil em um cenário real: o projeto UTIs brasileiras. Revista Brasileira de Terapia Intensiva, 4 (1), 34-44.
Montes, P. S., et al. (2017). Uso de corticosteroides em pacientes com sepse: uma revisão bibliográfica. Revista Brasileira de Terapia Intensiva, 4 (8), 1-8.
Moskowitz, A. et al. (2020). Effect of Ascorbic Acid, Corticosteroids, and Thiamine on Organ Injury in Septic Shock: The ACTS Randomized Clinical Trial. JAMA, 324 (7), 642-650.
Neta, A. B. C. S., et al. (2020). Relações da corticoterapia no tratamento do choque séptico. Brazilian Journal of Health Review, 3 (1), 1324-1330.
Ramanan, M., et al. (2019). Steroids and Sepsis: The Debate Continues. International Anesthesiology Clinics, 57 (2), 17-30.
Rocha, S. L., et al. (2011). Resposta hemodinâmica após uso de corticoide na sepse experimental. Revista do Médico Residente, 13 (1), 1-11.
Rygård, S. L. et al. (2018). Low-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis. Intensive Care Med, 44 (7), 1003-1016.
Salluh, J., et al. (2017). Corticosteroids in Severe Sepsis and Septic Shock. Shock, 47 (1), 47-51.
Shi, R., et al. (2020). Benefit of hydrocortisone, thiamine, and vitamin C for patients with sepsis or septic shock? Too early to draw conclusions. Critical Care, 24(1), 18-28.
Souza, C. N. S., et al. (2017). Sepse em ambiente hospitalar. Brazilian Journal of Health Review, 1 (7), 15-24.
Tagami, T. et al. (2014). Low-dose corticosteroid use and mortality in severe communityacquired pneumonia patients The European Respiratory Journal, 45 (2), 463-472.
Taniguchi, L. U., et al. (2019). Disponibilidade de recursos para tratamento da sepse no Brasil: uma amostra aleatória de instituições brasileiras. Revista Brasileira de Terapia Intensiva, 31 (2), 193-201.
Tavaré A. et al. (2017). Recognition, diagnosis, and early management of sepsis: NICE guideline. Br J Gen Pract, 67 (1), 185-166.
Vandewalle, J., et al. (2020). Glucocorticoids in Sepsis: To Be or Not to Be. Front. Immunol., 11 (13), 1-11.
Yao, Y., et al. (2019). Are corticosteroids beneficial for sepsis and septic shock? based on pooling analysis of 16 studies. Frontiers in pharmacology, 10 (8), 714-718.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Melina Fonseca Maia França Coury Alves; Bárbara Queiroz de Figueiredo; Bruno Faria Coury; Flávia Garcia Freitas; Julia da Cunha Ribeiro; Júlia de Sousa Oliveira; Júlia Silva Coimbra Costa; Juliana Silva Neiva; Rúbia Carla Oliveira
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
