This study investigated the effects of hydrocortisone therapy on patients with septic shock. It found no significant difference in 28-day mortality between patients given hydrocortisone and those given placebo. While hydrocortisone hastened the reversal of shock, it also increased risks of superinfection and hyperglycemia. Based on these results, hydrocortisone cannot be recommended as general therapy for septic shock patients.

1. Hydrocortisone Therapy for Patients with Septic Shock (CORTICUS) PRENTED BY M.A.MONEIM NGHA - DAMMAM ICU January 10, 2008

8. Arms Experimental Placebo Comparator Intervention Intervention Placebo Placebo Drug hydrocortisone sodium succinate hydrocortisone sodium succinate 50 mg intravenous bolus every six hours for 5 days, then tapered to 50 mg intravenously every 12 hours for days 6-8, 50 mg every 24 hours for days 9-11 and then stopped Drug

9. Patients 500 -1(consent was withdrawn) 499 Hydrocortisone 252 Placebo 248 No response to corticotropin 125/108 233 ( % 46.7) Response To corticotropin 136 unknown4(2.4%) Response To corticotropin 118 Unknown 8 Projected 800 P Slow recruitment Termination of funding Time expiry of the trial drug

11. Demographic Characteristics of the Patients, According to Subgroup

12. Clinical Characteristics of the Patients at Baseline, According to Subgroup Results

17. MV The number of extubated patients on day 28 was similar in the two study groups Antibiotics There was no significant difference in outcome between study groups among patients receiving appropriate antibiotic therapy and those receiving inappropriate therapy Etomidate Among the 96 patients who had received Etomidate, 58(60.4%) did not have a response to corticotropin, as compared with 175 of 403 who did not receive etomidate (43.4%, P = 0.004) Results

27. Outcomes According to Subgroup