Updating evidence role corticosteroids severe sepsis septic shock
Even at dose equivalency, some corticosteroids have more immunosuppressive properties (e.g., dexamethasone), and some have more mineralocorticoid and vasoreactive properties (e.g., hydrocortisone) .
This, tied with the evidence that endogenous glucocorticoids are secreted in a pulsatile manner in health , major surgery  and critical illness  warranted further analysis of the effects of the individual drugs and the dose regimens used.
Two authors (BG, TM) extracted data and cross-checked this for accuracy against the original publications. Where the treatment regimen was not published, one author (BG) attempted to contact the authors.
If the authors were unable to be contacted, the study was excluded.
However, the definition of hyperglycaemia between studies varied so widely that it was not possible to group the results.
One author (TM) drew up a data extraction table from the Rev Man file that was amended by the other authors.
Second, do steroids given to all critically ill patients improve outcomes ?
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Multiple corticosteroids and treatment regimens have been used as adjuncts in the treatment of septic shock.
Qualitative and quantitative differences exist at cellular and tissular levels between the different drugs and their patterns of delivery.