Articles Tagged With: hydrocortisone
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Considerations and Concerns with Vitamin C in Sepsis and Septic Shock
Sepsis remains a major healthcare problem associated with significant morbidity and mortality. Roles for hydrocortisone, ascorbic acid (vitamin C), and thiamine (HAT therapy) as potential adjuvants remain controversial.
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ORANGES and ACTS Trials: No Mortality Benefit with Ascorbic Acid, Thiamine, and Hydrocortisone in Septic Shock Patients
Two double-blinded, placebo-controlled, randomized trials involving 337 patients (ORANGES, n = 137; ACTS, n = 200) with sepsis and septic shock have shown that administration of ascorbic acid, thiamine, and hydrocortisone did not reduce organ dysfunction or improve overall mortality. However, both trials showed that this combination therapy was effective in reducing the time to achieve shock resolution or shock-free days.
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Vitamin C, Thiamine, and Hydrocortisone for Septic Shock
The combination of vitamin C, thiamine, and hydrocortisone did not improve outcomes compared with hydrocortisone alone in patients with septic shock.
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Corticosteroid Administration in Sepsis May Be Associated With Lower 28-Day Mortality
In this systematic review and meta-analysis of randomized, controlled trials comparing administration of corticosteroids with placebo or standard supportive care in sepsis, corticosteroids were associated with reduced 28-day mortality.
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Evaluation and Treatment of Adrenal Insufficiency in the Emergency Department
This article addresses the pathophysiology, discusses various clinical presentations, and reviews current evidence-based practices for managing adrenal insufficiency and crisis in the emergency department.
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Re-evaluating Steroid Therapy in Septic Shock
Two recent trials have provided more data regarding steroid therapy for septic shock.