Özet:

Objective: In patients with unreacted septic shock to vasopressor treatment, the hemodynamic response with steroid treatment has been shown to improve; this condition is called adrenal insufficiency associated with critical disease. Therefore, non-response to the fluid and vasopressor treatment, septic shock steroid therapy has taken place in many studies and international guidelines. This study aims to investigate the effects of plasma cortisol levels and steroid therapy on intensive care mortality in patients monitored with septic shock. Instruments and Methods: Between February 2008 and October 2010 patients with septic shock diagnosis in the Internal Disease Intensive Care Unit of the University of Gazi Medical Faculty were examined retrospectively. At the start of the shock, the cortizol levels were considered and the steroid started as a patient working group. The age, gender, periods of stay in the intensive care unit, mechanical ventilation needs, acute physiology and chronic health assessment (APACHE)II score and Glasgow coma score, albumin, C reactive protein(CRP), spot blood sugar values were recorded, daily insulin doses were recorded. The final points were chosen as shock output, intensive care stay time and mortality. A total of 91 patients were taken to the study. Patients were divided into two groups as those with plasma cortisol ≤15μg/dL and those with >15μgr/dL.In 22 patients (24.2%), the plasma cortisol level was ≤15μg/dL.   There was no statistical difference in terms of demographic data compared to the two groups. However, the intensive care mortality rate was statically significantly high, regardless of steroid treatment, in the group with plasma cortisol value >15μg/dL. Patients were compared in terms of whether they were taking steroid treatment or not. While there was no difference in retention, the group of steroids found a shorter intensive care stay time. Result: In patients with septic shock with plasma cortisol levels >15μg/dL, the intensive care mortality was higher than in patients with ≤15μg/dL. Steroid treatment was to shorten the intensive care period.