Plasma Cortisol, Aldosterone, and Ascorbic Acid Concentrations in Patients with Septic Shock Do Not Predict Treatment Effect of Hydrocortisone on Mortality A Nested Cohort Study
Jeremy Cohen, Rinaldo Bellomo, Laurent Billot, Louise M Burrell, David M Evans, Simon Finfer, Naomi E Hammond, Qiang Li, David Liu, Colin McArthur, Brett McWhinney, John Moore, John Myburgh, Sandra Peake, Carel Pretorius, Dorrilyn Rajbhandari, Andrew Rhodes, Manoj Saxena, Jacobus PJ Ungerer, Morag J Young Show all
American Journal of Respiratory and Critical Care Medicine | AMER THORACIC SOC | Published : 2020
Rationale: Whether biomarkers can identify subgroups of patients with septic shock with differential treatment responses to hydrocortisone is unknown. Objectives: To determine if there is heterogeneity in effect for hydrocortisone on mortality, shock resolution, and other clinical outcomes based on baseline cortisol, aldosterone, and ascorbic acid concentrations. Methods: From May 2014 to April 2017, we obtained serum samples from 529 patients with septic shock from 22 ICUs in Australia and New Zealand. Measurements and Main Results: There were no significant interactions between the association with 90-day mortality and treatment with either hydrocortisone or placebo for total cortisol (..View full abstract
Awarded by National Health and Medical Research Council of Australia
Awarded by Health Research Council of New Zealand
Supported by project grants from the National Health and Medical Research Council of Australia (1004108, 1124926, 1085159) and the Health Research Council of New Zealand (12/206). Funding was received from the Intensive Care Foundation (Australia). R.B., S.F., J. Myburgh, and B.V. are supported by Practitioner Fellowships from the National Health and Medical Research Council and Medical Research Future Fund of Australia. D.M.E. is supported by a Senior Research Fellowship from the National Health and Medical Research Council of Australia (1137714).