Sprung CL, Annane D, Keh D, Moreno R, Singer M, Freivogel K, et al. N Engl J Med. 2008 Jan.10;358(2):111–24.
This European multicentre RCT compared hydrocortisone to placebo for 499 ICU patients with septic shock and found no difference in mortality despite quicker resolution of shock with hydrocortisone; the hydrocortisone patients had more episodes of superinfection including new sepsis. This landmark trial suggests no advantage and possible harm from routine use of hydrocortisone for septic shock.