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Design of Cecal Ligation and Puncture and Intranasal Infection Dual Model of Sepsis-Induced Immunosuppression
Published on: June 15, 2019
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Corticosteroids in sepsis: an updated systematic review and meta-analysis (protocol)
Bram Rochwerg1,2, Simon Oczkowski1, Reed Alexander Siemieniuk2
1Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
BMJ Open
|July 2, 2017
Summary
Corticosteroids may not improve survival in sepsis, despite their use in treating the infection. This systematic review re-evaluates recent trials to clarify the efficacy and safety of corticosteroid treatment for sepsis patients.
Area of Science:
- Critical care medicine
- Infectious diseases
- Pharmacology
Background:
- Sepsis involves a dysregulated host response to infection and impaired corticosteroid metabolism.
- Exogenous corticosteroids are considered a potential adjunctive therapy for sepsis.
- Existing trial data on corticosteroids for sepsis survival remain inconclusive.
Purpose of the Study:
- To systematically review updated evidence on the efficacy and safety of corticosteroids in sepsis patients.
- To address persistent uncertainty regarding the impact of corticosteroids on sepsis survival.
Main Methods:
- Comprehensive literature search including Cochrane, MEDLINE, EMBASE, LILACS, and clinical trial registries from October 2014 onwards.
- Inclusion of eligible randomized controlled trials investigating corticosteroid use in sepsis.
- Data synthesis using random-effect models, assessing relative risks and mean differences with 95% confidence intervals.
- Evaluation of evidence certainty using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
Main Results:
- The review synthesizes data from recent large randomized controlled trials.
- Effect estimates for dichotomous and continuous outcomes are presented with confidence intervals.
- Subgroup analyses are planned to explore potential variations in treatment effects.
Conclusions:
- The review aims to provide a clear summary of current evidence on corticosteroid efficacy and safety in sepsis.
- Findings will inform clinical decision-making regarding corticosteroid use in sepsis management.
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