Effect of hydrocortisone-fludrocortisone combination on mortality in septic shock: a systematic review and meta-analysis.
Background: This study assessed the effect of hydrocortisone-fludrocortisone combination therapy on the mortality of patients with septic shock. Methods: A literature search was conducted using Medline, Embase, the Cochrane Library, ClinicalTrials.gov, and other databases for articles published unti...
| Publicado en: | Infection Vol. 53; no. 2; pp. 553 - 561 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=184303351&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 184303351 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Apr2025 vid: 53 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 184303351 179270650 184303351 184303351 10.1007/s15010-024-02381-z 184303351 ppf: 553 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Effect of hydrocortisone-fludrocortisone combination on mortality in septic shock: a systematic review and meta-analysis. aug: au: Wu, Jheng-Yen Liu, Mei-Yuan Liu, Ting-Hui Huang, Po-Yu Restinia, Mita Hsu, Wan-Hsuan Tsai, Ya-Wen Chuang, Min-Hsiang Hung, Kuo-Chuan Lai, Chih-Cheng affil: https://ror.org/02y2htg06 Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan sug: subj: Shock, Septic Mortality Shock, Septic Drug Therapy Drug Combinations Therapeutic Use Hydrocortisone Therapeutic Use Hydrocortisone Pharmacodynamics Drug Combinations Pharmacodynamics Treatment Outcomes Evaluation Human Systematic Review Meta Analysis Survival Analysis Medline Embase Cochrane Library Descriptive Statistics Confidence Intervals Odds Ratio ab: Background: This study assessed the effect of hydrocortisone-fludrocortisone combination therapy on the mortality of patients with septic shock. Methods: A literature search was conducted using Medline, Embase, the Cochrane Library, ClinicalTrials.gov, and other databases for articles published until October 1, 2023. Only clinical studies that assessed the clinical efficacy and safety of hydrocortisone-fludrocortisone therapy for the treatment of septic shock were included. The primary outcome was the in-hospital mortality rate. Results: Seven studies with a total of 90, 756 patients were included. The study group exhibited lower in-hospital mortality rates (40.8% vs. 42.8%; OR, 0.86; 95% CI, 0.80–0.92). Compared to the control group, the study group also had lower intensive care unit (ICU) mortality (OR, 0.77; 95% CI, 0.63–0.95), 28-day mortality (OR, 0.85; 95% CI, 0.72–1.00), 90-day mortality (OR, 0.85; 95% CI, 0.71–1.01), 180-day mortality (OR, 0.82; 95% CI, 0.68–0.90), and one-year mortality (OR, 0.70; 95% CI, 0.42–1.16). Subgroup analyses showed a similar trend, particularly prominent in the pooled analysis of randomized clinical trials, multicenter studies, and ICU patients, the study drug regimen involved hydrocortisone at a dose of 50 mg every 6 h in combination with fludrocortisone at 50 µg daily, with the control group receiving either placebo or standard care. Hydrocortisone-fludrocortisone also increased vasopressor-free days and reduced vasopressor duration, without elevating the risk of adverse events. Conclusions: This study emphasizes the potential survival benefits of hydrocortisone-fludrocortisone combination therapy for patients with septic shock and its additional advantages, including reduced vasopressor use. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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