Tag: hydrocortisone
Effectiveness of Fludrocortisone and Hydrocortisone vs. Hydrocortisone Alone in Septic Shock
Steroid use in sepsis is controversial. For example, fludrocortisone–hydrocortisone together may improve survival in septic shock, while hydrocortisone alone may not. A recent subgroup analysis of the APROCCHSS trial... read more
Hydrocortisone, Ascorbic Acid, and Thiamine Combination Therapy Efficacy for the Management of Sepsis and Septic Shock
In this systematic review, we found that hydrocortisone, ascorbic acid, and thiamine (HAT) regimen may be useful for reducing the duration of vasopressor use and improve organ functions in patients with sepsis and septic... read more
Regular Old Pneumonia Treatment Just Got Better
In 2020, COVID-19 pneumonia became so common that "old-fashioned" bacterial pneumonia suddenly seemed rare. They look very different on x-ray. See if you can spot the differences. A new study from France tipped the scales... read more
Hydrocortisone in Severe Community-Acquired Pneumonia
Among patients with severe community-acquired pneumonia being treated in the ICU, those who received hydrocortisone had a lower risk of death by day 28 than those who received placebo. A total of 800 patients had undergone... read more
Sepsis is scurvy? Vitamin C, Thiamine, and Steroids
I have avoided commenting on vitamin C for sepsis, because commentary seemed rather unnecessary. The hype was obviously ridiculous. The chances of it helping were clearly low. The evidence of benefit was negligible. Others... read more
Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS
Current literature addressing the pharmacological principles guiding glucocorticoid (GC) administration in ARDS is scant. This paucity of information may have led to the heterogeneity of treatment protocols and misinterpretation... read more
External Corroboration That Corticosteroids May Be Harmful to Septic Shock Endotype A Patients
This exploratory analysis provides further evidence that corticosteroid exposure may be associated with increased mortality among septic shock endotype A patients. We previously reported gene expression-based endotypes... read more
Effect of Hydrocortisone on Mortality and Organ Support in Patients with Severe COVID-19
Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority... read more
Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock
Using adjunctive hydrocortisone therapy yields a significant monetized benefit based on inputs from the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock and Activated Protein C and Corticosteroids... read more
Hydrocortisone Prevents Immunosuppression by interleukin-10+ Natural Killer Cells After Trauma-Hemorrhage
These data demonstrate that trauma-induced immunosuppression is characterized by an interleukin-10-dependent elimination of dendritic cell by natural killer cells and that hydrocortisone improves outcome by limiting this... read more
Effect of Vitamin C and Thiamine on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock
A 2020 randomized trial reported no difference in duration of time alive and free of vasopressor administration at 7 days among intensive care unit (ICU) patients with septic shock assigned to vitamin C, thiamine, and hydrocortisone... read more
Wide Interest in a Vitamin C Drug Cocktail for Sepsis Despite Lagging Evidence
Critical care medicine specialist Paul Marik, MD, has described himself as a status quo destabilizer, and probably nothing illustrates that designation better than the sepsis treatment known as the Marik protocol. In the... read more
Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock
In patients with septic shock, treatment with intravenous vitamin C, hydrocortisone, and thiamine, compared with intravenous hydrocortisone alone, did not significantly improve the duration of time alive and free of vasopressor... read more
Heterogeneity of Treatment Effect by Baseline Risk of Mortality in Critically ill Patients
Randomised controlled trials (RCTs) enrolling patients with sepsis or acute respiratory distress syndrome (ARDS) generate heterogeneous trial populations. Non-random variation in the treatment effect of an intervention due... read more
Septic Shock: Innovative Treatment Options in the Wings
Vitamin C, angiotensin-II, and methylene blue are emerging options on the cutting edge of refractory septic shock treatment that require more investigation, but nevertheless appear promising, Rishi Rattan, MD, said at the... read more
It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock
The administration of a continuous infusion of hydrocortisone to a general population of patients in septic shock on mechanical ventilation cannot be recommended at this time. The authors conclusion that glucocorticoids do... read more
The ADRENAL Trial: Steroids in Septic Shock
Randomized clinical trials evaluating the efficacy of adjunctive corticosteroids in septic shock have shown conflicting evidence of clinical relevance. Two trials in particular looked at lower dose hydrocortisone (200mg/day)... read more
