التفاصيل البيبلوغرافية
| العنوان: |
Corticosteroid therapy in refractory shock following cardiac arrest: a randomized, double-blind, placebo-controlled, trial. |
| المؤلفون: |
Donnino, Michael W., Andersen, Lars W., Berg, Katherine M., Chase, Maureen, Sherwin, Robert, Smithline, Howard, Carney, Erin, Long Ngo, Patel, Parth V., Xiaowen Liu, Cutlip, Donald, Zimetbaum, Peter, Cocchi, Michael N., Ngo, Long, Liu, Xiaowen, collaborating authors from the Beth Israel Deaconess Medical Center’s Center for Resuscitation Science Research Group |
| المصدر: |
Critical Care; 4/3/2016, Vol. 20, p82-82, 1p |
| مصطلحات موضوعية: |
CARDIAC arrest, COMPARATIVE studies, CARDIOPULMONARY resuscitation, HYDROCORTISONE, RESEARCH methodology, MEDICAL cooperation, RESEARCH, RESEARCH funding, SHOCK (Pathology), SURVIVAL, TIME, EVALUATION research, VASOCONSTRICTORS, RANDOMIZED controlled trials, TREATMENT effectiveness, PROPORTIONAL hazards models, BLIND experiment, THERAPEUTICS |
| مستخلص: |
Background: The purpose of this study was to determine whether the provision of corticosteroids improves time to shock reversal and outcomes in patients with post-cardiac arrest shock.Methods: We conducted a randomized, double-blind trial of post-cardiac arrest patients in shock, defined as vasopressor support for a minimum of 1 hour. Patients were randomized to intravenous hydrocortisone 100 mg or placebo every 8 hours for 7 days or until shock reversal. The primary endpoint was time to shock reversal.Results: Fifty patients were included with 25 in each group. There was no difference in time to shock reversal between groups (hazard ratio: 0.83 [95% CI: 0.40-1.75], p = 0.63). We found no difference in secondary outcomes including shock reversal (52% vs. 60%, p = 0.57), good neurological outcome (24% vs. 32%, p = 0.53) or survival to discharge (28% vs. 36%, p = 0.54) between the hydrocortisone and placebo groups. Of the patients with a baseline cortisol < 15 ug/dL, 100% (6/6) in the hydrocortisone group achieved shock reversal compared to 33% (1/3) in the placebo group (p = 0.08). All patients in the placebo group died (100%; 3/3) whereas 50% (3/6) died in the hydrocortisone group (p = 0.43).Conclusions: In a population of cardiac arrest patients with vasopressor-dependent shock, treatment with hydrocortisone did not improve time to shock reversal, rate of shock reversal, or clinical outcomes when compared to placebo.Clinical Trial Registration: Clinicaltrials.gov: NCT00676585, registration date: May 9, 2008. [ABSTRACT FROM AUTHOR] |
|
Copyright of Critical Care is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder