Combined Therapy with Corticosteroids and Vasopressin in a Patient with Septic Shock
Septic shock is a critical physiological state of infection-related inadequacy of tissue perfusion and hypotension that is often refractory to fluid resuscitation.1 It is associated with a high mortality rate, especially in the setting of multiorgan dysfunction and if the initial antimicrobial therapy administered is inappropriate.2,3 Appropriate antimicrobial therapy is the cornerstone of treatment, but adjunctive approaches have also been explored in recent years. Impairment of endogenous adrenal function and vasopressin deficiency are common in patients with septic shock.4,5 Exogenous supplementation with corticosteroids had a proven mortality benefit in a specific set of critically ill patients,6 and the benefits of vasopressin are slowly emerging.7 However, the net effect of combination treatment with exogenous corticosteroids and vasopressin in patients with septic shock is unknown. This report documents a case in which combination therapy was employed, and the literature on corticosteroid and vasopressin supplementation in septic shock is reviewed.
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