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4120781 
Journal Article 
Effects of high dose corticosteroids in patients with septic shock: prospective, controlled study 
Sprung, CL; Caralis, PV; Marcial, EH; Pierce, M; Karpf, M; Et al 
1984 
1 
New England Journal of Medicine
ISSN: 0028-4793
EISSN: 1533-4406 
IPA/85/625079 
Engl 
REF 29 
1137-1143 
English 
IPA COPYRIGHT: ASHP To determine whether corticosteroids are efficacious in severe septic shock, a prospective study was conducted on 59 patients randomly assigned to intravenous injection of 30 mg/kg of methylprednisolone sodium succinate (I), 6 mg/kg of dexamethasone sodium phosphate (II), or control group, 17.5 +- 5.4 h after the onset of shock. Four (19%) of 21 I-treated, 7 (32%) of 22 II-treated, and none of the 16 control patients had reversal of shock 24 h after drug administration. Patients treated with corticosteroids within 4 h after the onset of shock had a higher incidence of shock reversal. At 133 h after drug administration, 17 (40%) of 43 corticosteroid-treated patients and 11 (69%) of 16 control patients died. The differences in reversal of shock and survival disappeared later in the course. Overall, 16 (76%) of 21 patients receiving I, 17 (77%) of 22 patients receiving II and 11 (69%) of 16 controls in the hospital died. It was concluded that corticosteroids do not improve the overall survival of patients with severe, late septic shock but may be helpful early in the course and in certain subgroups of patients.