Effect of low dose hydrocortisone on duration of vasopressor therapy in septic shock.

ABSTRACT

Background & objectives:Severe sepsis and septic shock are major health problems. Stress dose of hydrocortisone infusion reduces the time of cessation of vasopressor therapy in septic shock. This study was planned to see the role of low dose corticosteroids on duration of vasopressor therapy in patients with septic shock along with their outcome. Methods: The study was carried out in 40 patients of septic shock. The patients were randomized into two groups i.e. treatment (Group A) and the placebo (Group B) groups of 20 each. Both groups received antibiotics, vasopressors i.e. Dopamine and Norepinephrine and IV fluids along with low dose hydrocortisone being administered only to Group A. Mean values were compared statistically using t-test and z-test. Results: The mean time spent in shock (hours) in survivors was 44.00 ± 11.2 (p< 0.001) while in group B was 72.00 ± 0.00 (p< 0.05). Also, the number of survivors in group A was more with cortisol levels of 5-25 mcg/ml. Interpretation & conclusion:Low dose hydrocortisone reduced the time spent in shock in survivors of group A, thereby reducing duration of vasopressor therapy. It also reduced mortality in subgroup of patients with serum cortisol levels of 5-25 mcg/ml proving that moderately low cortisol levels are benefitted more with hydrocortisone therapy than those with relatively high cortisol levels.