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Keh1 D et al. – This summary provides information about the role of the central stress hormone cortisol and contrasts the concept of relative adrenal insufficiency in septic shock with the concept of corticosteroid insufficiency in severe systemic inflammation. Current data and newest meta–analyses are critically evaluated; possible side effects of this therapy are discussed. Finally, evidence–based recommendations for the application of low–dose hydrocortisone in patients with severe septic shock are provided.

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