Table 1 Recently completed randomized, controlled trials of cortisol replacement in septic shock
From: Cortisol replacement for severe sepsis and septic shock: what should I do?
Study | Methods | Participants | Interventions | Outcome | Comments |
|---|---|---|---|---|---|
Bollaert et al., 1998 [2] | Randomized, two-center, double blind, parallel groups | N = 41, adults only Vasopressor-dependent septic shock | Hydrocortisone, 300 mg per day (100 mg i.v. bolus) for 5 days and then either stopped (if no effect on shock reversal) or progressively tapered; or placebo | Shock reversal, death, complications | Improved time to shock reversal in 28-day survival No increase in complication rates |
Briegel et al., 1999 [3] | Randomized, monocenter, double blind, parallel groups | N = 40, adults only Vasopressor-dependent septic shock | Hydrocortisone, loading dose of 100 mg in 30 min followed by continuous infusion 0.18 mg/kg per h for 6 days and then progressively tapered in steps of 24 mg/day; or placebo | Shock reversal, organ dysfunction, death | Improved time to shock reversal in organ dysfunction free-days No increase in complication rates |
Chawla et al., 1999 [4] | Randomized, monocenter, double blind, parallel groups | N = 41, adults only Vasopressor-dependent septic shock | Hydrocortisone, 300 mg per day (100 mg i.v. bolus) for 5 days and then either stopped (if no effect on shock reversal) or progressively tapered; or placebo | Shock reversal, death, complications | Improved time to shock reversal in 28-day survival No increase in complication rates |
Keh et al., 1999 [5] | Randomized, placebo-controlled, monocenter, double blind, crossover | N = 40, adults only Vasopressor-dependent septic shock | Hydrocortisone, loading dose of 100 mg in 30 min followed by continuous infusion 0.18 mg/kg per hour for 3 days; or placebo | Systemic inflammation, systemic and pulmonary hemodynamics, vasopressor requirement, complications | Improvement in systemic inflammation, hemodynamics, and vasopressor requirements No increase in complication rates |
Annane, 2000 [6] | Randomized, placebo-controlled, multicenter, double blind, parallel groups | N = 300, adults only Vasopressor-dependent and ventilator-dependent septic shock | Hydrocortisone 200 mg/day (50 mg i.v. bolus) + fludrocortisone 50 μg/day (oral) for 7 days or their respective placebo | 28-day survival, shock reversal, organ dysfunction reversal, complications | Improvement in shock reversal and mortality No increase in complication rates |