CORTICUS

Corticosteroid Therapy of Septic Shock

Paciente / Población Intervención / Exposición Comparación Desenlace

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

499

Diseño

Double-blind RCT

Desenlace

28-day mortality in ACTH non-responders

Relevancia

Resultado39.2% 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

Discusión y crítica

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