Abstract
Background
Physiologic dose hydrocortisone is part of the suggested adjuvant therapies for patients
with septic shock. However, the association between the corticosteroid therapy and
mortality in patients with septic shock is still not clear. Some authors considered
that the mortality is related to the time frame between development of septic shock
and start of low dose hydrocortisone. Thus we designed a placebo-controlled, randomized
clinical trial to assess the importance of early initiation of low dose hydrocortisone
for the final outcome.
Methods
A total of 118 patients with septic shock were recruited in the study. All eligible
patients were randomized to receive hydrocortisone (n = 58) or normal saline (n = 60). The study medication (hydrocortisone and normal saline) was initiated simultaneously
with vasopressors. The primary end-point was 28-day mortality. The secondary end-points
were the reversal of shock, in-hospital mortality and the duration of ICU and hospital
stay.
Results
The proportion of patients with reversal of shock was similar in the two groups (P = 0.602); There were no significant differences in 28-day or hospital all-cause mortality;
length of stay in the ICU or hospital between patients treated with hydrocortisone
or normal saline.
Conclusion
The early initiation of low-dose of hydrocortisone did not decrease the risk of mortality,
and the length of stay in the ICU or hospital in adults with septic shock.
Trial registration: www.clinicaltrials.gov NCT02580240.
Keywords
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Article Info
Publication History
Published online: June 05, 2017
Accepted:
June 4,
2017
Received in revised form:
May 1,
2017
Received:
February 15,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
