Hydrocortisone Infusion for Severe Community-acquired Pneumonia

Clinical effects of adding fludrocortisone to a hydrocortisone-based shock protocol in hypotensive critically ill children

“…Previous multicenter studies employing high-dose corticosteroids empirically in septic adults showed no benefit and potential harm [1][2][3][4]. However, interest was renewed by encouraging results using lower doses of corticosteroids in critically ill adults with relative or absolute adrenal insufficiency [5][6][7][8][9]. A randomized trial of low-dose steroid supplementation demonstrated mortality benefit in adults with relative adrenal insufficiency [1].…”

Mortality reduction in severe community-acquired pneumonia: key findings from a large randomized controlled trial and their clinical implications

“…In terms of the justification for employing hydrocortisone, Jalloul et al ( 9 ) aimed to compare the studies conducted by Confalonieri et al and Annane et al ( 8 , 10 ). In Annane et al ’s large RCT, patients with adrenal insufficiency, indicated by a non-response to the corticotropin test (a cortisol rise of more that 9 g/dL after administration of 250 micrograms of corticotropin), showed a higher likelihood of benefitting from cortisol supplementation, resulting in 1-month survival rates of 37% vs. 47% (P<0.02) ( 10 ).…”