Initiation of hydrocortisone treatment for pneumonia induced septic shock: a prospective clinical study

Abstract

Objective To assess the effect of early initiation of low dose hydrocortisone on mortality in patients with pneumonia induced septic shock. Methods A prospective randomized controlled trial (RCT) was conducted in Department of Critical Care Medicine of Northern Jiangsu People′s Hospital. Fifty-four patients with pneumonia induced septic shock from September 2015 to February 2017 were enrolled in this study. Patients were randomly assigned to receive hydrocortisone or 0.9% sodium chloride solution at the same time of the vasopressors were initiated. In this study, 28-day mortality, hospital all-cause mortality, reversal of shock, length of stay in the ICU and hospital were recorded to evaluate the effect of early initiation of low-dose hydrocortisone treatment in patients with pneumonia induced septic shock. Results There were no significant differences in 28-day or hospital all-cause mortality; reversal of shock; length of stay in the ICU or hospital between patients treated with hydrocortisone and placebo (all P>0.05). The binary logistic regression model showed that duration of mechanical ventilation up to day 28 was an independent risk factor of 28-day mortality (P<0.05). Conclusion The early initiation of low-dose hydrocortisone did not decrease mortality, and the length of stay in the ICU or hospital in adults with pneumonia induced septic shock. Key words: Pneumonia; Septic shock; Hydrocortisone; Mortality