Sepsis Clinical Pathway – Emergency Department, Inpatient and PICU

Consider Stress Dose Hydrocortisone

Indications

If hemodynamic stability is not restored despite adequate fluid resuscitation and titration of vasoactive therapy, consider stress dose hydrocortisone for Critical Illness-Related Corticosteroid Insufficiency (CIRCI). For each patient, the risk/benefit ratio of administering corticosteroid should be weighed, considering uncertain benefit of steroid in septic shock and patient specific risk.

Dosing

Refer to Stress Dose Steroid Pathway.

Discontinuing Hydrocortisone

Wean or discontinue hydrocortisone when vasoactive therapy no longer required.