ReviewJournal of anesthesia, analgesia and critical care2026
Continuous vs. intermittent infusion of corticosteroids in septic shock: a GRADE-based systematic review and meta-analysis.
Review in Journal of anesthesia, analgesia and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 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
2 citing papers in PubMed.
- A clinician's guide to corticosteroid therapy in pneumonia and critical illness: agent selection, dosing, monitoring, and interactions.Pneumonia (Nathan Qld.) · 2026Review
- [Hydrocortisone for septic shock: with or without fludrocortisone?]Die Anaesthesiologie · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeptic shock is a fatal infection-induced syndrome causing severe organ dysfunction and high mortality. The study aimed to comprehensively evaluate the effects of continuous versus intermittent bolus hydrocortisone treatment in patients with septic shock, addressing all relevant primary and secondary outcomes.
methodsPubMed, Embase, Scopus, and Web of Science were systematically searched from inception to June 1, 2025, with additional manual sources. Eligible studies included randomized controlled trials and cohort studies of adults with septic shock comparing continuous infusion versus intermittent bolus hydrocortisone. This review followed PRISMA guidelines. Risk of bias was assessed using the Cochrane RoB 2 tool for RCTs and ROBINS-I for cohort studies. Certainty of evidence was graded via the GRADE framework. Primary outcomes were ICU, hospital, and 28-day mortality. Secondary outcomes included 7-day shock reversal, ICU-acquired weakness, ICU and hospital length of stay, vasopressor-free days, duration of vasopressor therapy, and metabolic complications.
resultsThis study included 14 studies comparing continuous infusion and intermittent bolus administration of hydrocortisone in patients with septic shock. The findings indicated no significant differences in ICU mortality, hospital mortality, or 28-day mortality between the two groups. However, continuous infusion was associated with significantly improved 7-day shock reversal, reduced risk of hypokalemia, and lower glycemic variability. No significant differences were found between the groups in terms of ICU and hospital length of stay, insulin requirements, and other variables.
conclusionThese findings suggest that continuous infusion may provide clinical benefits in specific aspects of the management of septic shock patients.
trial registrationPROSPERO CRD420251069956.
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