Dr Manu Shankar-Hari, Reader in Critical Care Medicine

One of our researchers, Dr Manu Shankar-Hari, was recently part of an international team creating a clinical practice guideline for sepsis. The guideline was published in the British Medical Journal and found that corticosteroids may be a valid treatment for some patients, giving doctors another tool for treating this dangerous condition.

Dr Shankar-Hari is a Consultant in Intensive Care Medicine at Guy’s and St Thomas’ NHS Foundation Trust and was recently made a Reader in Critical Care Medicine at King’s College London. He was part of an international panel which included clinicians, researchers and patients. They reviewed existing practice and studies to understand the risks and potential benefits of using corticosteroids as a treatment for patients with sepsis. Opinion among doctors has been divided about this treatment, so the team carefully reviewed a range of evidence.

Sepsis is a serious complication of an infection. Without quick treatment, sepsis can lead to multiple organ failure and death. One in in three admissions to intensive care units in England is a case of sepsis. Of these admissions, a third of patients die within days of being admitted to hospital. Currently the main treatment for sepsis is antibiotics, alongside fluids and oxygen to help the body cope with the effects of the condition.

Corticosteroids were not previously recommended for people with sepsis, as there was not enough evidence that they would help. Based on new evidence, the panel found that corticosteroids have a mild benefit to patients and crucially only mild side effects. They issued guidance that corticosteroids can be used alongside current treatments for sepsis.

Dr Shankar-Hari said: “Scientists have thought for a while that corticosteroids may have a beneficial effect for patients, as they raise the blood pressure and help bring the immune system under control. Standard treatment alone might be an option for some patients. While expert opinion on the use of corticosteroids in sepsis remains divided, the new guideline gives doctors another tool to consider for treating this dangerous condition.”