ArticleIntensive care medicine2007
Impact of bolus application of low-dose hydrocortisone on glycemic control in septic shock patients.
Article in Intensive care medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 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.
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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.
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Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- 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
- [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Guideline
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012.Intensive care medicine · 2013Guideline
- Tight glycaemic control by an automated algorithm with time-variant sampling in medical ICU patients.Intensive care medicine · 2008Trial
- Diffuse Large B-cell Lymphoma with Severe Lactic Acidosis and Liver Failure: A Case Report and Literature Review.Internal medicine (Tokyo, Japan) · 2025Review
- 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
- Glucocorticoid therapy for sepsis in the AI era: a survey on current and future approaches.Computational and structural biotechnology journal · 2024Review
- In-hospital mortality in SARS-CoV-2 stratified by the use of corticosteroid.Annals of medicine and surgery (2012) · 2022Article
- Effect of Corticosteroids on Mortality in Hospitalized COVID-19 Patients Not Receiving Invasive Mechanical Ventilation.Clinical pharmacology and therapeutics · 2021Observational
- Corticosteroid treatment has no effect on hospital mortality in COVID-19 patients.Scientific reports · 2021Article
- Hyperglycemia Risk Evaluation of Hydrocortisone Intermittent Boluses vs Continuous Infusion in Septic Shock: A Retrospective Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2021Article
- Corticosteroids in Acute Lung Injury: The Dilemma Continues.International journal of molecular sciences · 2019Review
- Hydrocortisone in septic shock: all the questions answered?Journal of thoracic disease · 2018Article
- Evaluation of Hydrocortisone Continuous Infusion Versus Intermittent Boluses in Resolution of Septic Shock.P & T : a peer-reviewed journal for formulary management · 2017Article
- Timing, method and discontinuation of hydrocortisone administration for septic shock patients.World journal of critical care medicine · 2017Article
- Associations between bolus infusion of hydrocortisone, glycemic variability and insulin infusion rate variability in critically Ill patients under moderate glycemic control.Annals of intensive care · 2015Article
- Review
- Life-threatening ANCA-positive vasculitis associated with rickettsial infection.BMJ case reports · 2012Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether glycemic control is less feasible when hydrocortisone is given as a bolus compared with continuous application in septic shock patients.
designObservational prospective pilot study.
settingFourteen-bed surgical university hospital ICU. PATIENTS: Sixteen consecutive patients with septic shock receiving a continuous infusion of 200 mg hydrocortisone/day and an infusion regime of insulin keeping blood glucose below 150 mg/dl.
interventionBlood glucose and insulin infusion were adjusted to steady state before intervention. At baseline, the continuous hydrocortisone infusion was replaced with a single bolus of 50 mg hydrocortisone. During a subsequent 6-h period, blood glucose was monitored hourly and insulin infusion was kept constant. Afterwards, hydrocortisone application and adjustment of blood glucose was resumed according to standard treatment.
resultsMean blood glucose in steady state at baseline immediately prior to intervention was 128 mg/dl (range 114-141 mg/dl; 95% confidence interval). After bolus injection of hydrocortisone, blood glucose increased significantly within 6 h with peak levels of 154 mg/dl (range 132-178 mg/dl; p<0.01). Blood glucose returned to baseline with restoration of continuous hydrocortisone infusion. There were marked inter-individual variations with peak glucose values up to 254 mg/dl, but no significant difference in intra-individual glucose variability before and after bolus injection of hydrocortisone.
conclusionsBolus injections of hydrocortisone may induce significant increases of blood glucose in patients with septic shock. The individual response is highly variable and we speculate that repetitive boluses would induce marked undulation of blood glucose. In terms of glycemic-control strategies, a continuous infusion of hydrocortisone seems to be preferable.
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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.