Trial reportCritical care (London, England)2007
Effect of mode of hydrocortisone administration on glycemic control in patients with septic shock: a prospective randomized trial.
Trial report in Critical care (London, England), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 9 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 9 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- Continuous versus Intermittent Hydrocortisone for the Treatment of Septic Shock: A Systematic Review and Meta-Analysis.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2026Pooled it
- Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2025Pooled it
- Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis.Frontiers in immunology · 2021Pooled it
- Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2019Pooled it
- Impact and Beneficial Critical Points of Clinical Outcome in Corticosteroid Management of Adult Patients With Sepsis: Meta-Analysis and GRADE Assessment.Frontiers in pharmacology · 2019Pooled it
- Corticosteroid therapy for sepsis: a clinical practice guideline.BMJ (Clinical research ed.) · 2018Guideline
- Unexplained mortality differences between septic shock trials: a systematic analysis of population characteristics and control-group mortality rates.Intensive care medicine · 2018Pooled it
- Corticosteroids for treating sepsis.The Cochrane database of systematic reviews · 2015Pooled it
- Updating the evidence for the role of corticosteroids in severe sepsis and septic shock: a Bayesian meta-analytic perspective.Critical care (London, England) · 2010Pooled it
- Pre-emptive hydrocortisone therapy in early septic shock: a double-blind, allocation-concealed, pilot randomized controlled trial.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2025Trial
- Pathophysiological aspects of hyperglycemia in children with meningococcal sepsis and septic shock: a prospective, observational cohort study.Critical care (London, England) · 2011Trial
- The impact of a reduced dose of dexamethasone on glucose control after coronary artery bypass surgery.Cardiovascular diabetology · 2007Trial
- Continuous vs. intermittent infusion of corticosteroids in septic shock: a GRADE-based systematic review and meta-analysis.Journal of anesthesia, analgesia and critical care · 2026Review
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Journal of intensive care · 2025Article
- The Role of SR-BI in sepsis: leveraging mechanistic insights to advance precision steroid therapy.Frontiers in immunology · 2025Review
- Influence of hydrocortisone infusion method on the clinical outcome of patients with septic shock: A systematic review and meta-analysis.Journal of intensive medicine · 2025Article
- Steroid Therapy for Patients with Septic Shock: A Multicenter Observational Study Conducted in Japan.Internal medicine (Tokyo, Japan) · 2024Observational
- Glucocorticoid therapy for sepsis in the AI era: a survey on current and future approaches.Computational and structural biotechnology journal · 2024Review
- Effect of Continuous Infusion vs Bolus Dose of Hydrocortisone in Septic Shock: A Prospective Randomized Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Hydrocortisone for Septic Shock, Bolus or Infusion: Pro, Con, May be.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLow-dose hydrocortisone treatment is widely accepted therapy for the treatment of vasopressor-dependent septic shock. The question of whether corticosteroids should be given to septic shock patients by continuous or by bolus infusion is still unanswered. Hydrocortisone induces hyperglycemia and it is possible that continuous hydrocortisone infusion would reduce the fluctuations in blood glucose levels and that tight blood glucose control could be better achieved with this approach.
methodsIn this prospective randomized study, we compared the blood glucose profiles, insulin requirements, amount of nursing workload needed, and shock reversal in 48 septic shock patients who received hydrocortisone treatment either by bolus or by continuous infusion with equivalent dose (200 mg/day). Duration of hydrocortisone treatment was five days.
resultsThe mean blood glucose levels were similar in the two groups, but the number of hyperglycemic episodes was significantly higher in those patients who received bolus therapy (15.7 +/- 8.5 versus 10.5 +/- 8.6 episodes per patient, p = 0.039). Also, more changes in insulin infusion rate were needed to maintain strict normoglycemia in the bolus group (4.7 +/- 2.2 versus 3.4 +/- 1.9 adjustments per patient per day, p = 0.038). Hypoglycemic episodes were rare in both groups. No difference was seen in shock reversal.
conclusionStrict normoglycemia is more easily achieved if the hydrocortisone therapy is given to septic shock patients by continuous infusion. This approach also reduces nursing workload needed to maintain tight blood glucose control.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.