Researchers analyzed six studies involving 514 patients with cirrhosis who developed severe shock from infections. They wanted to see if low-dose corticosteroids, which are sometimes used to support blood pressure, helped these patients. The analysis combined two randomized trials and four observational studies.
The review found that corticosteroids helped resolve the shock state and reduced deaths specifically from shock that didn't respond to other treatments. However, this improvement in shock did not lead to better overall survival during the hospital stay. Patients receiving corticosteroids also had more gastrointestinal bleeding and new organ failure.
Because this analysis mixed different study types and showed mixed results, doctors need to be cautious. The treatment helped with shock but didn't improve survival and came with serious risks. Patients and families should understand that while corticosteroids might help with certain shock symptoms, they don't appear to help people with cirrhosis survive their hospital stay and may cause additional problems.