Corticosteroids in sepsis: An updated systematic review and meta-analysis (protocol)

Rochwerg, Bram, Oczkowski, Simon, Siemieniuk, Reed Alexander, Menon, Kusum, Szczeklik, Wojciech, English, Shane, Agoritsas, Thomas, Belley-Cote, Emilie, D'Aragon, Frederick, Alhazzani, Waleed, Duan, Erick, Gossack-Keenan, Kira, Sevransky, Jon, Vandvik, Per, Venkatesh, Bala, Guyatt, Gordon and Annane, Djillali (2017) Corticosteroids in sepsis: An updated systematic review and meta-analysis (protocol). BMJ Open, 7 6: e016847.1-e016847.7. doi:10.1136/bmjopen-2017-016847


Author Rochwerg, Bram
Oczkowski, Simon
Siemieniuk, Reed Alexander
Menon, Kusum
Szczeklik, Wojciech
English, Shane
Agoritsas, Thomas
Belley-Cote, Emilie
D'Aragon, Frederick
Alhazzani, Waleed
Duan, Erick
Gossack-Keenan, Kira
Sevransky, Jon
Vandvik, Per
Venkatesh, Bala
Guyatt, Gordon
Annane, Djillali
Title Corticosteroids in sepsis: An updated systematic review and meta-analysis (protocol)
Journal name BMJ Open   Check publisher's open access policy
ISSN 2044-6055
Publication date 2017-06-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1136/bmjopen-2017-016847
Open Access Status DOI
Volume 7
Issue 6
Start page e016847.1
End page e016847.7
Total pages 7
Place of publication London, United Kingdom
Publisher BMJ Publishing Group
Language eng
Subject 2700 Medicine
Abstract Introduction Sepsis is associated with a dysregulated host response to infection and impaired endogenous corticosteroid metabolism. As such, therapeutic use of exogenous corticosteroids is a promising adjunctive intervention. Despite a large number of trials examining this research question, uncertainty persists regarding the effect of corticosteroids on survival in sepsis. Several large randomised controlled trials have been published recently prompting a re-evaluation of the available literature. Methods and analysis A rigorous and reproducible search and screening process from a Cochrane review on the same topic was comprehensive to October 2014. We will search MEDLINE, EMBASE, LILACS, the Cochrane trial registry and clinicaltrials.gov for eligible randomised controlled trials investigating the use of corticosteroids in patients with sepsis from September 2014. Outcomes have been chosen by a semi-independent guideline panel, created in the context of a parallel BMJ Rapid Recommendation on the topic. This panel includes clinicians, content experts, methodologists and patient representatives, who will help identify patient-important outcomes that are critical for deciding whether to use or not use corticosteroids in sepsis. Two reviewers will independently screen and identify eligible studies; a third reviewer will resolve any disagreements. We will use RevMan to pool effect estimates from included studies for each outcome using a random-effect model. We will present the results as relative risk with 95% CI for dichotomous outcomes and as mean difference or standardised mean difference for continuous outcomes with 95% CI. We will assess the certainty of evidence at the outcome level using the Grading of Recommendations, Assessment, Development and Evaluation approach. We will conduct a priori subgroup analyses, which have been chosen by the parallel BMJ Rapid Recommendation panel. Ethics and dissemination The aim of this systematic review is to summarise the updated evidence on the efficacy and safety of corticosteroids in patients with sepsis. Trial registration number CRD42017058537.
Keyword Corticosteroids
Intensive care
Meta-analysis
Sepsis
Shock
Systematic review
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
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