Hydrocortisone plus Fludrocortisone for Adults with Septic Shock

The New England Journal of Medicine
Djillali AnnaneCRICS-TRIGGERSEP Network

Abstract

Septic shock is characterized by dysregulation of the host response to infection, with circulatory, cellular, and metabolic abnormalities. We hypothesized that therapy with hydrocortisone plus fludrocortisone or with drotrecogin alfa (activated), which can modulate the host response, would improve the clinical outcomes of patients with septic shock. In this multicenter, double-blind, randomized trial with a 2-by-2 factorial design, we evaluated the effect of hydrocortisone-plus-fludrocortisone therapy, drotrecogin alfa (activated), the combination of the three drugs, or their respective placebos. The primary outcome was 90-day all-cause mortality. Secondary outcomes included mortality at intensive care unit (ICU) discharge and hospital discharge and at day 28 and day 180 and the number of days alive and free of vasopressors, mechanical ventilation, or organ failure. After drotrecogin alfa (activated) was withdrawn from the market, the trial continued with a two-group parallel design. The analysis compared patients who received hydrocortisone plus fludrocortisone with those who did not (placebo group). Among the 1241 patients included in the trial, the 90-day mortality was 43.0% (264 of 614 patients) in the hydrocortisone-plus-f...Continue Reading

References

Aug 21, 2002·JAMA : the Journal of the American Medical Association·Djillali AnnaneEric Bellissant
Jan 11, 2005·Lancet·Djillali AnnaneJean-Marc Cavaillon
Dec 26, 2007·Critical Care Medicine·R Phillip DellingerUNKNOWN World Federation of Societies of Intensive and Critical Care Medicine
Jan 11, 2008·The New England Journal of Medicine·Charles L SprungUNKNOWN CORTICUS Study Group
Dec 19, 2012·Proceedings of the National Academy of Sciences of the United States of America·Julie E GoodwinWilliam C Sessa
Mar 26, 2013·American Journal of Respiratory and Critical Care Medicine·Djillali AnnaneUNKNOWN APROCCHSS Trial Investigators
Dec 2, 2014·The Lancet. Respiratory Medicine·Djillali Annane, Tarek Sharshar
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Manu Shankar-HariUNKNOWN Sepsis Definitions Task Force
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Mervyn SingerDerek C Angus
May 8, 2016·Annals of Intensive Care·Djillali AnnaneUNKNOWN APROCCHSS Investigators for the TRIGGERSEP Network
Jul 6, 2016·Frontiers in Endocrinology·Djillali Annane
Jul 16, 2016·British Journal of Clinical Pharmacology·Andrea PolitoJean-Claude Alvarez
Nov 2, 2016·JAMA : the Journal of the American Medical Association·Didier KehUNKNOWN SepNet–Critical Care Trials Group
Jan 20, 2017·Intensive Care Medicine·Andrew RhodesR Phillip Dellinger
Apr 27, 2017·Critical Care Medicine·Fouad FadelFrédéric Jaisser

❮ Previous
Next ❯

Citations

Mar 1, 2018·The New England Journal of Medicine·Anthony F Suffredini
Jun 21, 2018·Critical Care Medicine·Grant C Lynde, Craig S Jabaley
Jul 7, 2018·Critical Care Medicine·Bram RochwergGordon Guyatt
Aug 30, 2018·The New England Journal of Medicine·Balasubramanian VenkateshUNKNOWN ADRENAL investigators
Sep 22, 2018·Current Opinion in Critical Care·Catia CillónizAntoni Torres
Oct 10, 2018·Current Opinion in Infectious Diseases·Jean-Louis Vincent, Wasineenart Mongkolpun
Nov 18, 2018·Critical Care Medicine·Maria Vargas, Giuseppe Servillo
Dec 7, 2018·Pharmacotherapy·Mitchell S BuckleySandra L Kane-Gill
Jan 17, 2019·Medical Sciences : Open Access Journal·Nicolò Maria VanoniFrancesco Blasi
Feb 9, 2019·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·T SchmochM A Weigand
Jan 16, 2019·Pharmacotherapy·Gretchen L SachaIshaq Lat
Feb 12, 2019·Intensive Care Medicine·Daniel De BackerKeith R Walley
Feb 13, 2019·Internal Medicine Journal·Kelly ThompsonSimon Finfer
Feb 25, 2019·The Cochrane Database of Systematic Reviews·Louise LansburyWei Shen Lim
Feb 13, 2019·Expert Review of Anti-infective Therapy·Jean-Louis Vincent, Wasineenart Mongkolpun
Feb 6, 2019·Current Opinion in Anaesthesiology·Mark E Nunnally, Arpit Patel
Mar 12, 2019·Journal of Pharmacy Practice·Judith Jacobi
Jan 11, 2019·BMJ : British Medical Journal·Jason T Poston, Jay L Koyner
Dec 13, 2018·American Journal of Respiratory and Critical Care Medicine·Brendon P Scicluna, J Kenneth Baillie
Oct 27, 2018·American Journal of Respiratory and Critical Care Medicine·David B AntcliffeAnthony C Gordon
Mar 10, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Steven M Lemieux, Alexander R Levine
May 6, 2019·Critical Care : the Official Journal of the Critical Care Forum·Shalini SanthakumaranManu Shankar-Hari
May 17, 2019·Critical Care Medicine·Kelly Roveran GengaJames A Russell
Dec 6, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Douglas A SimonettoPatrick S Kamath
Jul 19, 2019·Journal of Intensive Care Medicine·Farid SadakaJacklyn O'Brien
Jul 12, 2019·Expert Review of Clinical Pharmacology·Jean-Louis Vincent, Yasser Sakr
Aug 8, 2018·Der Anaesthesist·C J ReußT Brenner
Apr 30, 2019·American Journal of Respiratory and Critical Care Medicine·Nadir YehyaRon W Reeder
Aug 20, 2019·Future Oncology·Franklin CastilleroOscar Arrieta
Oct 17, 2018·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Jordi RieraRicard Ferrer
Nov 19, 2019·Critical Care Medicine·Balasubramanian Venkatesh, Jeremy Cohen
Oct 1, 2019·Critical Care Medicine·James A Russell, Jonathan Sevransky
Jul 2, 2019·Critical Care Medicine·Djillali Annane
Jun 5, 2019·Critical Care Medicine·David B Antcliffe, Anthony C Gordon
Sep 15, 2019·Intensive Care Medicine·Balasubramanian VenkateshJeremy Cohen
Dec 7, 2019·The Cochrane Database of Systematic Reviews·Djillali AnnaneBram Rochwerg
Aug 27, 2019·Journal of the American Geriatrics Society·Yoland F PhilpottsMatthew R Baldwin
Sep 13, 2019·Nature Reviews. Nephrology·Natalja L Stanski, Hector R Wong

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The New England Journal of Medicine
Stephane LegrielHYBERNATUS Study Group
The New England Journal of Medicine
Balasubramanian VenkateshADRENAL Trial Investigators and the Australian–New Zealand Intensive Care Society Clinical Trials Group
Annals of Intensive Care
Djillali AnnaneAPROCCHSS Investigators for the TRIGGERSEP Network
The New England Journal of Medicine
Anthony C GordonDeborah Ashby
© 2022 Meta ULC. All rights reserved