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Original Article Hydrocortisone Therapy for Patients with Septic Shock Charles L. Sprung, M.D., Djillali Annane, M.D., Ph.D., Didier Keh, M.D., Rui Moreno, M.D., Ph.D., Mervyn Singer, M.D., F.R.C.P., Klaus Freivogel, Ph.D., Yoram G. Weiss, M.D., Julie Benbenishty, R.N., Armin Kalenka, M.D., Helmuth Forst, M.D., Ph.D., Pierre-Francois Laterre, M.D., Konrad Reinhart, M.D., Brian H. Cuthbertson, M.D., Didier Payen, M.D., Ph.D., Josef Briegel, M.D., Ph.D., for the CORTICUS Study Group N Engl J Med Volume 358(2):111-124 January 10, 2008
Cortisol response to corticotropin and survival in septic shock. Lancet, 1991
Rothwell PM , Udwadia ZF , Lawler PG . Intensive Therapy Unit, South Cleveland Hospital, Middlesbrough, UK. Corticotropin stimulation tests were used to assess adrenocortical function in 32 patients with septic shock. 13 patients had a poor cortisol response (rise less than 250 nmol/l) to corticotropin, all of whom died. However, there were only 6 deaths among the 19 patients with adequate responses (p less than 0.001). These results suggest that some patients with septic shock may have relative adrenocortical insufficiency.
A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock RC Bone, CJ Fisher, TP Clemmer, GJ Slotman, CA Metz, and RA Balk N Engl J Med Volume 317:653-658 September 10, 1987 Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. The Veterans Administration Systemic Sepsis Cooperative Study Group
Hydrocortisone did not improve survival or reversal of shock in patients with septic shock, either overall or in patients who did not have a response to corticotropin, although hydrocortisone hastened reversal of shock in patients in whom shock was reversed