Adrenal Insufficiency in Septic Shock
Summary
Randomized controlled trial evaluating the duration of steroid replacement therapy in patients with adrenal insufficiency and septic shock. Patients will be randomized to receive either hydrocortisone 50 mg IV every six hours for seven days (control) or hydrocortisone 50 mg IV every six hours until 24 hours after achievement of hemodynamic stability (MAP > 65 mm Hg off of vasopressors).
Study Design
Allocation: Randomized, Control: Dose Comparison, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Conditions
Septic Shock
Intervention
Corticosteroid, Corticosteroid
Location
The Methodist Hospital
Houston
Texas
United States
77030
Status
Recruiting
Source
The Methodist Hospital System
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00842933
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Desonide
A nonfluorinated corticosteroid anti-inflammatory agent used topically for DERMATOSES.
Prednisolone
A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states.
Flurandrenolone
A corticosteroid used topically in the treatment of various skin disorders. It is usually employed as a cream or an ointment, and is also used as a polyethylene tape with an adhesive. (From Martindale, The Extra Pharmacopoeia, 30th ed, p733)
Paramethasone
A glucocorticoid with the general properties of corticosteroids. It has been used by mouth in the treatment of all conditions in which corticosteroid therapy is indicated except adrenal-deficiency states for which its lack of sodium-retaining properties makes it less suitable than HYDROCORTISONE with supplementary FLUDROCORTISONE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p737)
Vasoplegia
Condition of low SYSTEMIC VASCULAR RESISTANCE that develops secondary to other conditions such as ANAPHYLAXIS; SEPSIS; SURGICAL SHOCK; and SEPTIC SHOCK. Vasoplegia that develops during or post surgery (e.g., CARDIOPULMONARY BYPASS) is called postoperative vasoplegic syndrome or vasoplegic syndrome.
Clinical Trials
The proposed study will evaluate the potential benefit of a tapered course of hydrocortisone compared to abrupt cessation in patients initiated on hydrocortisone for septic shock. The stu...
Corticosteroid Therapy of Septic Shock - Corticus
The purpose of the study is to determine whether steroids decrease 28-day mortality in patients with septic shock.
Glycosaminoglycans During Septic Shock - a Temporal Study
We have previously shown that the plasma level of glycosaminoglycans (GAG) in septic shock patients are elevated compared to controls. The purpose of this study is to investigate the tempo...
Phenylephrine Versus Norepinephrine in Septic Shock
Clinical studies evaluating the clinical use of phenylephrine in septic shock are lacking. The present study was designed to compare the effects of norepinephrine and phenylephrine on syst...
Thiamine as a Metabolic Resuscitator in Septic Shock
The major goal of this project is to determine whether the use of thiamine in patients with septic shock will result in attenuation of lactic acidosis and a more rapid reversal of shock.
PubMed Articles
ABSTRACT: INTRODUCTION: Current low (stress) dose corticosteroid regimens may have therapeutic advantage in severe sepsis and septic shock despite conflicting results from two landmark randomised cont...
Outcomes of Etomidate in Severe Sepsis and Septic Shock.
Abstract BACKGROUND: The use of single-dose etomidate to facilitate intubation in critically ill patients has recently been debated given its suppression of steroidogenesis with possible resultant adv...
Management of corticosteroid-induced osteoporosis.
Treatment with corticosteroids can adversely affect bone metabolism. In particular, it lowers bone mineral density (BMD) and increases the likelihood of fragility fractures, the hallmarks of osteoporo...
PURPOSE: To study the value of free versus total cortisol levels in assessing relative adrenal insufficiency during critical illness-related corticosteroid insufficiency. METHODS: A prospective study...
11-Deoxycortisol is a corticosteroid hormone in the lamprey.
Corticosteroid hormones are critical for controlling metabolism, hydromineral balance, and the stress response in vertebrates. Although corticosteroid hormones have been well characterized in most ver...
