ReviewCritical care explorations2020
The Efficacy, Safety, and Optimal Regimen of Corticosteroids in Sepsis: A Bayesian Network Meta-Analysis.
Review in Critical care explorations, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Corticosteroids for sepsis and septic shock: a meta-analysis of 18 RCTs with dose-stratified and fludrocortisone subgroup evaluation.BMC anesthesiology · 2025Pooled it
- Targeting sepsis through inflammation and oxidative metabolism.World journal of critical care medicine · 2025Review
- High expression of L-GILZ transcript variant 1 (GILZ TV 1) is associated with increased 30-day sepsis mortality, and a high expression ratio possibly contraindicates hydrocortisone administration.Critical care (London, England) · 2024Article
- Steroids in the Management of Ionotropic-Resistant Septic Shock: A Comprehensive Review of Efficacy and Outcomes.Cureus · 2024Review
- Drug-resistant seizures associated with hyperinflammatory monocytes in FIRES.Annals of clinical and translational neurology · 2023Article
- Preventative Management of Sepsis-Induced Acute Respiratory Distress Syndrome in the Geriatric Population.Cureus · 2023Review
- IFIH1/IRF1/STAT1 promotes sepsis associated inflammatory lung injury via activating macrophage M1 polarization.International immunopharmacology · 2023Article
- The DEXA-SEPSIS study protocol: a phase II randomized double-blinded controlled trial of the effect of early dexamethasone in high-risk sepsis patients.Clinical and experimental emergency medicine · 2022Article
- Acute kidney injury secondary to urinary tract infection in kidney transplant recipients.Scientific reports · 2022Article
- Effects of Glucocorticoid Therapy on Sepsis Depend Both on the Dose of Steroids and on the Severity and Phase of the Animal Sepsis Model.Life (Basel, Switzerland) · 2022Article
- Research frontiers and trends in the application of artificial intelligence to sepsis: A bibliometric analysis.Frontiers in medicine · 2022Article
- To stress or not to stress: Brain-behavior-immune interaction may weaken or promote the immune response to SARS-CoV-2.Neurobiology of stress · 2021Article
- Sepsis and Coronavirus Disease 2019: Common Features and Anti-Inflammatory Therapeutic Approaches.Critical care medicine · 2020Article
- Assessment of Machine Learning to Estimate the Individual Treatment Effect of Corticosteroids in Septic Shock.JAMA network open · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Conventional systematic reviews have indicated that corticosteroids might result in a slight reduction in mortality in sepsis. However, the efficacy, safety, and optimal regimen of different corticosteroids partly remain unknown. In this study, we conducted a Bayesian network meta-analysis for a head-to-head comparison of the therapeutic efficacy and safety of currently used corticosteroids in sepsis.
designA Bayesian network meta-analysis for a head-to-head comparison of the therapeutic efficacy and safety of currently used corticosteroids in sepsis.
settingA total of 35 eligible randomized controlled trials of corticosteroid use in sepsis. PATIENTS: The present Bayesian network meta-analysis included 8,859 patients with sepsis.
interventionsRandomized controlled trials were screened from PubMed, Embase, and the Cochrane Library up to December 28, 2019. A head-to-head comparison of the therapeutic efficacy and safety between the different categories of corticosteroids from the trials was conducted by Bayesian network meta-analysis. An empirical Bayesian meta-regression and a post hoc Bayesian network meta-analysis were performed to explore the appropriate dose and therapeutic duration of steroids for sepsis. MEASUREMENTS AND MAIN
resultsA total of 35 randomized controlled trials including 8,859 patients with sepsis were enrolled in the final analysis. Bayesian network meta-analysis revealed that methylprednisolone and dexamethasone might be more effective in reducing short-term mortality in sepsis than placebo: methylprednisolone versus placebo (relative risk, 0.65, 95% credible interval 0.40-0.93), dexamethasone versus placebo (relative risk, 0.42, 95% credible interval, 0.24-0.84). Hydrocortisone and hydrocortisone plus fludrocortisone were superior to placebo in days to shock resolution (
conclusionsThis study provided moderate evidence that the dosage of 200-400 mg per day of hydrocortisone or equivalent for 4-7 days was most likely to benefit septic patients.
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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.