What steroid regimen do you use in patients with both septic shock and ARDS?
Do you use hydrocortisone 200 mg/day as studied in ADRENAL/APROCCHSS or dexamethasone 20 mg/day as studied in DEXA-ARDS?
Answer from: at Academic Institution
Personally, I have used Hydrocortisone 50mg q6h for patients with refractory shock, regardless of the presence of absence of ARDS.
I have not been an adopter of Steroids in ARDS.
I use the random cortisol level to determine relative versus actual adrenal insufficiency. Shock reversal is accelerated with hydrocortisone although I haven't experienced a huge survival benefit.