CORTICUS

Corticosteroid Therapy of Septic Shock

Patient / Population Intervention / Exposure Comparison Outcome

In 499 patients with septic shock, hydrocortisone 200 mg/day did not reduce 28-day mortality versus placebo.

499

Design

Double-blind RCT

Endpoint

28-day mortality in ACTH non-responders

Relevance

Result39.2% vs 36.1% (p=0.69); overall 34.3% vs 31.5%.

Sprung CL, et al. N Engl J Med. 2008;358(2):111-124. 10.1056/NEJMoa071366

Discussion & critique

Discredited the ACTH stimulation test as a steroid-selection tool; tempered enthusiasm until ADRENAL/APROCCHSS reset the question.