بِسْمِ اللَّـهِ الرَّحْمَـٰنِ الرَّحِيمِ الَّذِي خَلَقَنِي فَهُوَ يَهْدِينِ وَالَّذِي هُوَ يُطْعِمُنِي وَيَسْقِينِ وَإِذَا مَرِضْتُ فَهُوَ يَشْفِينِ
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Septic shock

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Hossam Elgnainy Selected answer as best November 8, 2024
Hanan Nassar

If known or suspected adrenal insufficiency, the dose of IV hydrocortisone is 50-100 mg/m2/day(2-4 mg/kg/day) intermittent or continuous infusion max 200mg/day
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In cases where fluid resuscitation and IV vasopressor therapy are insufficient for achieving hemodynamic stability, both the Surviving Sepsis Campaign (SSC) and the American College of Critical Care Medicine recommend the administration of hydrocortisone.

early initiation of hydrocortisone (within three hours) appears to have favorable effects on clinical outcomes in critically ill patients, particularly in terms of timing for discontinuing vasopressors. https://doi.org/10.7759/cureus.50814

Hossam Elgnainy Selected answer as best November 8, 2024

The typical corticosteroid used in adults with septic shock is IV hydrocortisone at a dose of 200 mg/day given as 50 mg intravenously every 6 h or as a continuous infusion.

the previous answer was in adult,
for pediatric:
The SSC suggest against using IV hydrocortisone to treat children
with septic shock if fluid resuscitation and vasopressor therapy
are able to restore hemodynamic stability
https://www.sccm.org/sccm/media/ssc/SSC-Childrens-Guidelines-Microlearning-Corticosteroids.pdf

Side note:
you can use the “BSA-Adult Method” in the Pediatric Dose Calculator, to calculate the pediatric dose from the adult dose.
https://samraph.com/pediatric-dose-calculator/

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