• Sophia Bonnin, John J Radosevich, Yong Gu Lee, Jeremy P Feldman, and Jeffrey F Barletta.
• Dignity Health - St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ 85013, United States of America.
• J Crit Care. 2021 Apr 1; 62: 111-116.

PurposeThis study aims to describe differences in shock reversal between hydrocortisone 200 mg and 300 mg per day dosing regimens in patients with septic shock.MethodsThis is a multi-center retrospective study including patients admitted to intensive care units with septic shock receiving vasopressors and hydrocortisone between 2013 and 2018. We compared patients who received low dose hydrocortisone (50 mg every 6 h) versus high dose hydrocortisone (100 mg every 8 h) on the primary outcome of shock reversal.Results319 patients (low dose group, n = 134 and high dose group, n = 185) were included. In the multivariate regression model, high-dose steroids were associated with shock reversal [OR (95% CI) = 2.278 (1.063-4.880), p = 0.034]. This was not confirmed in the propensity score matched analysis [OR (95% CI) =2.202 (0.892-5.437), p = 0.087]. High dose steroids were associated with a lower need for additional vasopressor therapy (22% vs. 34%, p = 0.012) and lower shock recurrence (6.7% vs. 16%, p = 0.013), which was confirmed with propensity score matching.ConclusionsLow and high dose hydrocortisone have similar rates of shock reversal in septic shock patients. Hydrocortisone 100 mg every 8 h may reduce rates of recurrence of shock and reduce the need for additional vasopressors.Copyright © 2020 Elsevier Inc. All rights reserved.

15 keywords...

hide…