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The DOI matches its Crossref record; 5 of the 5 references it cites were found in a registry or an index.

Hydrocortisone Therapy for Patients with Septic Shock

Open access
Sprung, Charles L., Annane, Djillali, Keh, Didier, Moreno, Rui, Singer, Mervyn, Freivogel, Klaus, Weiss, Yoram G., Benbenishty, Julie, Kalenka, Armin, Forst, Helmuth, Laterre, Pierre-Francois, Reinhart, Konrad, Cuthbertson, Brian H., Payen, Didier, Briegel, Josef·2008·New England Journal of Medicine
DOI 10.1056/nejmoa071366
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Abstract

BACKGROUND: Hydrocortisone is widely used in patients with septic shock even though a survival benefit has been reported only in patients who remained hypotensive after fluid and vasopressor resuscitation and whose plasma cortisol levels did not rise appropriately after the administration of corticotropin. METHODS: In this multicenter, randomized, double-blind, placebo-controlled trial, we assigned 251 patients to receive 50 mg of intravenous hydrocortisone and 248 patients to receive placebo every 6 hours for 5 days; the dose was then tapered during a 6-day period. At 28 days, the primary outcome was death among patients who did not have a response to a corticotropin test. RESULTS: Of the 499 patients in the study, 233 (46.7%) did not have a response to corticotropin (125 in the hydrocortisone group and 108 in the placebo group). At 28 days, there was no significant difference in mortality between patients in the two study groups who did not have a response to corticotropin (39.2% in the hydrocortisone group and 36.1% in the placebo group, P=0.69) or between those who had a response to corticotropin (28.8% in the hydrocortisone group and 28.7% in the placebo group, P=1.00). At 28 days, 86 of 251 patients in the hydrocortisone group (34.3%) and 78 of 248 patients in the placebo group (31.5%) had died (P=0.51). In the hydrocortisone group, shock was reversed more quickly than in the placebo group. However, there were more episodes of superinfection, including new sepsis and septic shock. CONCLUSIONS: 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. (ClinicalTrials.gov number, NCT00147004.)

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Metadata

Authors
Sprung, C. L., Annane, D., Keh, D., Moreno, R., Singer, M., Freivogel, K., Weiss, Y. G., Benbenishty, J., Kalenka, A., Forst, H., Laterre, P.-F., Reinhart, K., Cuthbertson, B. H., Payen, D., & Briegel, J.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2008-01-10
Volume
358
Issue
2
Pages
111-124
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa071366
OpenAlex
W2113535256
Cited by
2,132
References
5
FWCI
155.78
Type
journal article
Language
en
Open access
green

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