• Respirology · Oct 2011

    Randomized Controlled Trial Comparative Study

    Low-dose hydrocortisone treatment for patients with septic shock: a pilot study comparing 3days with 7days.

    • Jin Won Huh, Hye-Sook Choi, Chae-Man Lim, Younsuck Koh, Yeon Mok Oh, Tae Sun Shim, Sang D O Lee, Woo Sung Kim, Dong Soon Kim, and Sang-Bum Hong.
    • Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
    • Respirology. 2011 Oct 1;16(7):1088-95.

    Background And ObjectiveAlthough there is controversy regarding the benefit of low-dose corticosteroid therapy in patients with septic shock, the Surviving Sepsis Campaign has advocated that low-dose intravenous hydrocortisone be used to treat adult septic shock patients. This study investigated the effect of the duration of a stress dose of hydrocortisone on survival of septic shock patients with relative adrenal insufficiency.MethodsOne hundred and thirty consecutive patients who met the American College of Chest Physicians/Society of Critical Care Medicine criteria for septic shock were included in the study. An additional inclusion criterion was vasopressor support after fluid resuscitation. The primary end-point was 28-day mortality, and the secondary end-points were shock reversal and mortality in the intensive care unit and hospital. All eligible patients were prospectively randomized to receive hydrocortisone treatment for 3 or 7days. Hydrocortisone treatment was started at a dose of 50mg every 6h.ResultsBaseline data at recruitment did not differ between the two groups. After 28days, mortality did not differ between the 3- and 7-day treatment groups (33.8% vs 36.9%, P=0.629). Mortality rates in the intensive care unit and hospital did not differ significantly between the two groups. The median time to withdrawal of vasopressor therapy was 5.0days in the 3-day treatment group and 6.4days in the 7-day treatment group (P=0.102).ConclusionsThis pilot study showed that in patients with septic shock and relative adrenal insufficiency, 28-day mortality did not differ between those treated with low-dose hydrocortisone for 3 or 7days.© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology.

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