Journal of Critical Care
Volume 22, Issue 4 , Pages 324-329 , December 2007

Low-dose steroid therapy does not affect hemodynamic response in septic shock patients

  • Joan M. Raurich, MD, PhD

      Affiliations

    • Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, 07014 Palma de Mallorca, Spain
    • Corresponding Author InformationCorresponding author. Tel.: + 34 971 175 152; fax: + 34 971 175 152.
    • ,
  • Juan A. Llompart-Pou, MD

      Affiliations

    • Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, 07014 Palma de Mallorca, Spain
    • ,
  • Jordi Ibáñez, MD, PhD

      Affiliations

    • Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, 07014 Palma de Mallorca, Spain
    • ,
  • Guillem Frontera, MD

      Affiliations

    • Unidad de Investigación, Hospital Universitario Son Dureta, 07014 Palma de Mallorca, Spain
    • ,
  • Olatz Pérez, MD

      Affiliations

    • Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, 07014 Palma de Mallorca, Spain
    • ,
  • Laura García, MD

      Affiliations

    • Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, 07014 Palma de Mallorca, Spain
    • ,
  • José I. Ayestarán, MD

      Affiliations

    • Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, 07014 Palma de Mallorca, Spain

References 

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  2. Annane D, Bellisant E, Cavaillon JM. Septic shock. Lancet. 2005;365:63–78
  3. Marik PE, Zaloga GP. Adrenal insufficiency in the critically ill. A new look at an old problem. Chest. 2002;122:1784–1796
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  7. Annane D, Sebille V, Charpentier C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone in patients with septic shock. JAMA. 2002;288:862–871
  8. Keh D, Boehnke T, Weber-Cartens S, et al. Immunologic and hemodynamic effects of “low-dose” hydrocortisone in septic shock. A double-blind, randomized, placebo-controlled, crossover study. Am J Respir Crit Care Med. 2003;167:512–520
  9. Oppert M, Reinicke A, Gräf KJ, Barckow D, Eckardt KU. Plasma cortisol levels before and during “low-dose” hydrocortisone therapy and their relationship to hemodynamic improvement in patients with septic shock. Intensive Care Med. 2000;26:1747–1755
  10. Marik PE. Unraveling the mystery of adrenal failure in the critically ill. Crit Care Med. 2004;32:596–597[Editorial]
  11. Elsouri N, Bander J, Guzman JA. Relative adrenal insufficiency in patients with septic shock; a close look to practice patterns. J Crit Care. 2006;21:73–78
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  13. Thys F, Laterre PF. Hydrocortisone in septic shock; too much, too little, too soon?. Crit Care Med. 2005;33:2683–2684[Editorial]
  14. Beishuizen A, Thijs JG. Relative adrenal failure in intensive care: in identifiable problem requiring treatment?. Best Pract Res Clin Endocrinol Metab. 2001;15:513–531
  15. de Jong MFC, Beishuizen A, Groeneveld ABJ. Defining relative adrenal insufficiency in the critically ill: the ACTH test revisited. In:  Vincent JL editors. Yearbook of intensive care and emergency medicine. Springer: Heidelberg; 2006;p. 539–550
  16. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31:1250–1256
  17. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA. 1993;270:2957–2963
  18. Ferreira FL, Bota DP, Bross A, Melot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001;286:1754–1758
  19. Joffe MM, Rosenbaum PR. Invited commentary: propensity scores. Am J Epidemiol. 1999;150:327–333
  20. Prignent H, Maxime V, Annane D. Science review: mechanisms of impaired adrenal function in sepsis and molecular actions of glucocorticoids. Crit Care. 2004;8:243–252
  21. Absalom A, Pledger D, Kong A. Adrenocortical function in critically ill patients 24 hours after a single dose of etomidate. Anaesthesia. 1999;54:861–867
  22. Bollaert PE, Charpentier C, Levy B, Debouverie M, Audibert G, Larcan A. Reversal of late septic shock with supraphysiological doses of hydrocortisone. Crit Care Med. 1998;26:645–650
  23. Chawla K, Kupfer Y, Tessler S. Hydrocortisone reverses refractory septic shock. Crit Care Med. 1999;27:A33;[Abstract]
  24. Annane D, Bellissant E, Bollaert PE, et al. Corticosteroids for severe sepsis and septic shock: a systematic review and meta-analysis. BMJ. 2004;329:480–488
  25. Minneci PC, Deans KJ, Banks SM, et al. Meta-analysis: the effect of steroids on survival and shock during sepsis depends on the dose. Ann Intern Med. 2004;141:47–56
  26. Vincent JL, Sakr Y, Sprung CL, et al. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med. 2006;34:344–353
  27. Garnacho Montero J, García-Garmedia JL, Barrero-Almodovar A, et al. Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis. Crit Care Med. 2003;31:2742–2751
  28. Loisa P, Uusaro A, Ruokonen E. A single adrenocorticotropic hormone stimulation test does not reveal adrenal insufficiency in septic shock. Anesth Analg. 2005;101:1792–1798
  29. Cohen J, Ward G, Prins J, Jones M, Venkatesh B. Variability of cortisol assays can confound the diagnosis of adrenal insufficiency in the critically ill population. Intensive Care Med. 2006;32:1901–1905
  30. Siraux V, De Backer D, Yavalatti G, et al. Relative adrenal insufficiency in patients with septic shock: comparison of low-dose and conventional corticotrophin tests. Crit Care Med. 2005;30:2479–2486
  31. Annane D. Low-dose adrenocorticotropic hormone test is not ready for routine adrenal function testing in the intensive care unit. Crit Care Med. 2005;33:2688–2689[Editorial]
  32. Marik PE, Zaloga GP. Adrenal insufficiency during septic shock. Crit Care Med. 2003;31:141–145
  33. Hamrahian AH, Oseni TS, Arafah BM. Measurements of serum free cortisol in critically ill patients. N Engl J Med. 2004;350:1629–1638

PII: S0883-9441(07)00085-8

doi: 10.1016/j.jcrc.2007.05.005

Journal of Critical Care
Volume 22, Issue 4 , Pages 324-329 , December 2007

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