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Septic shock requiring vasopressors — SCE Acute Medicine MCQ

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HardCritical Care MedicineSeptic shock requiring vasopressorsSCE Acute Medicine

A 67-year-old man with septic shock has received appropriate antibiotics, source control and fluids. He remains vasopressor-dependent despite norepinephrine 0.35 micrograms/kg/min plus vasopressin. Echocardiography shows no major pump failure. Which adjunct should now be considered?

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Correct answer: A — Give intravenous hydrocortisone at 200 mg per day

Intravenous hydrocortisone, commonly 200 mg daily by infusion or divided doses, is considered when adequate fluid resuscitation and vasopressors do not restore haemodynamic stability. It may shorten shock duration. It is not a substitute for source control, antibiotics or vasopressors, and very high-dose corticosteroid regimens are harmful.

Reference: https://doi.org/10.1007/s00134-026-08361-1