Continuous Hydrocortisone in Sepsis

Continuous Hydrocortisone Infusion Promotes Normoglycemia in Septic Shock Patients


Sepsis guidelines recommend the use of low-dose corticosteroids for vasopressor-dependent septic shock, and hydrocortisone has been shown in clinical trials to be effective in reversing septic shock and reducing mortality at a dosage of 200 to 300 mg daily in 3 or 4 divided doses administered by bolus or infusion

The question of whether corticosteroids should be given to septic shock patients by continuous or by bolus infusion is still unanswered. Hydrocortisone induces hyperglycemia and it is possible that continuous hydrocortisone infusion would reduce the fluctuations in blood glucose levels and that tight blood glucose control could be better achieved with this approach."

So the study concluded

Continuous administration of hydrocortisone infusions reduced the number of hyperglycemic episodes in patients with septic shock, according to the results of a prospective randomized trial reported in the February 16 issue of Critical Care.