TNF and Sepsis: To date, the Surviving Sepsis Campaign guidelines recommend short-course hydrocortisone (200–300 mg/day for ≤7 days or until vasopressor independence) as the sole adjunctive therapy for refractory septic shock (127).Preclinical studies suggest that early anti-TNF monoclonal antibody administration prevents lethal tissue damage during bacterial invasion, while delayed ethyl pyruvate-mediated reduction of serum HMGB1 concentrations rescues animals from sepsis-induced mortality.