COMMENTARY
Steroids in sepsis, etomidate and Pearl Harbor
1 Departments of Emergency Medicine and Critical Care, Manchester Royal Infirmary, Manchester, UK
2 Department of Anaesthetics, Manchester Royal Infirmary, Manchester, UK
Correspondence to:
Dr B A Foëx, Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK; bernard.foex@cmmc.nhs.uk
Accepted 25 March 2008
| The first 150 words of the full text of this article appear below. |
Steroids in sepsis, ... etomidate, ... Pearl Harbor, ... what’s the connection? Well, there is one, and it is relevant to the practice of emergency medicine.
Steroids have enjoyed mixed fortunes as part of the treatment for sepsis and multiple organ failure. When it was realised that an excessive inflammatory response was part of the pathogenesis of sepsis and multiple organ failure high-dose steroids seemed to have much to offer. Initial studies were encouraging.1 But then larger studies failed to show benefit and steroids fell out of favour.2 3 Things changed with increasing interest in the concept of adrenocortical failure or adrenocortical insufficiency in the critically ill.4 Low-dose, or physiological doses of steroids then came under scrutiny as an adjunct to treatment for severe sepsis and septic shock. The publication of a large randomised controlled trial5 and two meta-analyses, which suggested a survival benefit6 7 resulted in steroids being incorporated into the
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
