Hydrocortisone for use in pediatric septic shock, to reduce new or worsening organ failure

You may qualify if

• Attending physician expects to prescribe systemic corticosteroids for an indication other than septic shock
• Patient has received any doses of systemic corticosteroids during treatment for sepsis
• Enrolled concurrently in a competing interventional clinical trial (formal assessment to be conducted by SHIPSS Core Committee for each potential competing trial)
• Etomidate or ketoconazole treatment within past 48 hours
• Patient in whom steroids are contraindicated at time of screening (e.g. treatment for systemic fungal infection, cerebral malaria, strongyloides)
• Known or suspected hypothalamic, pituitary or adrenal disease (including patient has received acute or chronic corticosteroid administration and the physician intends to provide corticosteroid for suspected adrenal suppression)
• Attending physician, PICU care team, or legally recognized guardians not committed to full treatment and resuscitation at the time of screening
• Patient documented to be pregnant
• Previous enrollment in the SHIPSS study
• Patient admitted directly to the PICU with a thermal burn who has been in the PICU for <72 hours prior to meeting SHIPSS inclusion criteria.
• (U.S. sites only) Patient in the custody of US protective services
• Patient being evaluated for brain death
• Vasoactive-inotropic agents prescribed solely for an indication other than septic shock
• Confirmed dengue fever
• Age is at least 1 month (with corrected gestational age ≥42 weeks), but less than 17 years and 8 months of age
• A documented focus of infection or a strong suspicion of infection at PICU admission, or for patients who develop septic shock during PICU stay, at the onset of the septic shock event
• Surveillance cultures (e.g. blood, urine, cerebral spinal fluid, wound) and/or other microbial diagnostic tests have been obtained
• One or more antimicrobials have been prescribed
• Core temperature >38.5 C or <36.0 C or leukocytosis or leukopenia (as defined by the local laboratory) or a left-shifted leukocyte differential (>10% immature granulocyte forms) or a neutrophil count of <0.5 x 109 cells per litre documented at least once within the 24 hours preceding screening
• Treatment with a continuous infusion of vasoactive-inotropic agent(s) to maintain mean or systolic arterial blood pressure above the age-appropriate target set by the treating clinician
• Administration of two or more vasoactive-inotropic agents at any dose or epinephrine or norepinephrine infusion(s) alone at greater than or equal to 0.10 mcg/kg/min for >1 hour.

You can't join if

• A child receiving treatment in a pediatric intensive care unit for sepsis is ineligible for enrollment into SHIPSS if she/he meets any of the following exclusion criteria: