ReviewFrontiers in endocrinology2016
The Role of ACTH and Corticosteroids for Sepsis and Septic Shock: An Update.
Review in Frontiers in endocrinology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 77 citations in OpenAlex.
- Early hydrocortisone verses placebo in neonatal shock- a double blind Randomized controlled trial.Journal of perinatology : official journal of the California Perinatal Association · 2025Trial
- Corticotropin-stimulated steroid profiles to predict shock development and mortality in sepsis: From the HYPRESS study.Critical care (London, England) · 2022Trial
- ACTH and cortisol responses to CRH in acute, subacute, and prolonged critical illness: a randomized, double-blind, placebo-controlled, crossover cohort study.Intensive care medicine · 2018Trial
- Mineralocorticoid magic? Evaluating fludrocortisone in septic shock.British journal of clinical pharmacology · 2026Review
- Hydrocortisone Use for Septic Shock in Patients With CKD.Kidney international reports · 2026Article
- Comprehensive analysis of factors to consider when using glucocorticoids for sCAP: A review.Medicine · 2026Review
- Review
- Impact of Chronic Mild Stress on Neurotrophic and Hypothalamic-Pituitary-Adrenal Factors in the Brain of Rats Submitted to Sepsis.Neurotoxicity research · 2026Article
- The Differential Diagnosis between Pseudo Cushing's Syndrome and True Cushing's Syndrome in a Septic Patient in the Pre-Agonal Phase: A Case ReportEndocrine, metabolic & immune disorders drug targets · 2026Article
- High-density lipoprotein: a biomarker and therapeutic target in sepsis.Critical care (London, England) · 2025Review
- Unveiling the novel role of circadian rhythms in sepsis and septic shock: unexplored implications for chronotherapy.Frontiers in endocrinology · 2025Review
- [Therapeutic effects of glucocorticoids in patients with hematologic diseases with neutropenia and severe pneumonia classified by the PSI scores].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2024Article
- Novel cortisol trajectory sub-phenotypes in sepsis.Critical care (London, England) · 2024Article
- Hemodynamic management of septic shock: beyond the Surviving Sepsis Campaign guidelines.Clinical and experimental emergency medicine · 2023Article
- Alternatives to Hydrocortisone for Hemodynamic Support in Septic Shock Management Due to Medication Shortage.Critical care explorations · 2023Article
- Association of mortality with fludrocortisone addition to hydrocortisone treatment among septic shock patients: a propensity score matching analysis.Frontiers in medicine · 2023Article
- Characteristics and outcomes of patients with sepsis who had cortisol level measurements or received hydrocortisone during their intensive care unit management: A retrospective single center study.SAGE open medicine · 2023Article
- Field Experiences with Handheld Diagnostic Devices to Triage Children under Five Presenting with Severe Febrile Illness in a District Hospital in DR Congo.Diagnostics (Basel, Switzerland) · 2022Article
- The Many Roles of Cholesterol in Sepsis: A Review.American journal of respiratory and critical care medicine · 2022Review
- Fluids or vasopressors for the initial resuscitation of septic shock.Frontiers in medicine · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sepsis is a common disorder associated with high morbidity and mortality. It is now defined as an abnormal host response to infection, resulting in life-threatening dysfunction of organs. There is evidence from in vitro and in vivo experiments in various animal models and in patients that endotoxin or sepsis may directly and indirectly alter the hypothalamic-pituitary-adrenal response to severe infection. These alterations may include necrosis or hemorrhage or inflammatory mediator-mediated decreased ACTH synthesis, steroidogenesis, cortisol delivery to tissues, clearance from plasma, and decreased sensitivity of tissues to cortisol. Disruption of the hypothalamic-pituitary-adrenal axis may translate in patients with sepsis into cardiovascular and other organ dysfunction, and eventually an increase in the risk of death. Exogenous administration of corticosteroids at moderate dose, i.e., <400 mg of hydrocortisone or equivalent for >96 h, may help reversing sepsis-associated shock and organ dysfunction. Corticosteroids may also shorten the duration of stay in the ICU. Except for increased blood glucose and sodium levels, treatment with corticosteroids was rather well tolerated in the context of clinical trials. The benefit of treatment on survival remains controversial. Based on available randomized controlled trials, the likelihood of survival benefit is greater in septic shock versus sepsis patients, in sepsis with acute respiratory distress syndrome or with community-acquired pneumonia versus patients without these conditions, and in patients with a blunted cortisol response to 250 μg of ACTH test versus those with normal response.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.