الفهرس 
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Abstract
Septic shock is a life-threatening organ dysfunction caused by a dysregulated patient response to infection. Organ failure is the key predictor in the mortality of the cases of severe sepsis either due to the number of organs that fail or the degree of their failure. Vasopressors are needed to maintain systolic blood or mean blood pressure.
In patients suffering from septic shock and didn’t achieve hemodynamics with fluid resuscitation in addition to the vasopressors intravenous hydrocortisone is considered the medication of choice in shock reversal. The combination of hydrocortisone plus fludrocortisone in adults with septic shock who do not respond to initial resuscitation measures improves mortality and patient outcomes.
This study was conducted on 66 patients who were matching the inclusion criteria assigned randomly to 3 groups each containing 22 patients.
22 patients had received standard therapy for sepsis plus Hydrocortisone (Solucortef®, E.I.P.I.co. under license of Pfizer) at dose 50mg every 6 hours by Intra venous route. another 22 patients had received standard therapy for sepsis plus Hydrocortisone (Solucortef®) at dose of 50mg every 6 hours by Intra venous route and Fludrocortisone (Cortilon®, Amoun) 50 Microgram once daily by nasogastric tube for one week. The last 22 patients had received standard therapy for sepsis.
The results of the study showed that the use of corticosteroids (the hydrocortisone or the hydrocortisone plus fludrocortisone) in septic patients was associated with significant reduction in the time to wean from vasopressors and length of ICU stay. Meanwhile there were no significant effect of the mortality, rate SOFA score reduction and GIT bleeding and superinfection as corticosteroids adverse effects between the three groups.